{"id":"ef25b707801d","type":"article","url":"https://hartvaat.nl/2019/11/26/werkzaamheid-en-veiligheid-van-stents-bij-stemi-jacc-analyse/","title":"Werkzaamheid en veiligheid van stents bij STEMI: JACC analyse","title_en":"Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.09.038","source_url":"https://doi.org/10.1016/j.jacc.2019.09.038","authors":["Ply Chichareon","Rodrigo Modolo","Carlos Collet","Erhan Tenekecioglu","Maarten A Vink","Pyung Chun Oh","Jung-Min Ahn","Carmine Musto","Luis S Díaz de la Llera","Young-Seok Cho","Roberto Violini","Seung-Jung Park","Harry Suryapranata","Jan J Piek","Robbert J de Winter","Joanna J Wykrzykowska","Christian Spaulding","Woong Chol Kang","Ton Slagboom","Sjoerd H Hofma","Inge F Wijnbergen","Emilio Di Lorenzo","Nico H Pijls","Lorenz Räber","Salvatore Brugaletta","Manel Sabaté","Hans-Peter Stoll","Gregg W Stone","Stephan Windecker","Yoshinobu Onuma","Patrick W Serruys"],"significance":5,"published":"2019-11-26","source_date":"2019-11-26","image":"","kennis":[],"congress":"","summary_en":"This analysis compared the efficacy and safety of different drug-eluting stent types in STEMI, finding no clear superiority of any specific DES platform in the primary PCI setting.","created":"2026-07-03T10:28:17Z","updated":"2026-07-03T13:27:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Analyse van werkzaamheid en veiligheid van verschillende stenttypen bij STEMI.","abstract_original":"BACKGROUND: To date, no specific drug-eluting stent (DES) has fully proven its superiority over others in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. OBJECTIVES: The purpose of this study was to compare the safety and efficacy of coronary artery stents in STEMI patients in a patient-level network meta-analysis. METHODS: Eligible studies were dedicated randomized controlled trials comparing different stents in STEMI patients undergoing percutaneous coronary intervention with at least 12 months of clinical follow-up. Of 19 studies identified from the published data, individual patient data were collected in 15 studies with 10,979 patients representing 87.7% of patients in the overall network of evidence. The primary endpoint was the composite of cardiac death, reinfarction, or target lesion revascularization. RESULTS: Overall, 8,487 (77.3%) of 10,979 STEMI patients were male and the mean age was 60.7 years. At a median follow-up of 3 years, compared with bare-metal stents (BMS), patients treated with paclitaxel-, sirolimus-, everolimus-, or biolimus-eluting stents had a significantly lower risk of the primary endpoint (adjusted hazard ratios [HRs]: 0.74 [95% confidence interval (CI): 0.63 to 0.88], 0.65 [95% CI: 0.49 to 0.85], 0.70 [95% CI: 0.53 to 0.91], and 0.66 [95% CI: 0.49 to 0.88], respectively). The risk of primary endpoint was not different between patients treated with BMS and zotarolimus-eluting stents (adjusted HR: 0.83 [95% CI: 0.51 to 1.38]). Among patients treated with DES, no significant difference in the risk of the primary outcome was demonstrated. Treatment with second-generation DES was associated with significantly lower risk of definite or probable stent thrombosis compared with BMS (adjusted HR: 0.61 [95% CI: 0.42 to 0.89]) and first-generation DES (adjusted HR: 0.56 [95% CI: 0.36 to 0.88]). CONCLUSIONS: In STEMI patients, DES were superior to BMS with respect to long-term efficacy. No difference in long-term efficacy and safety was observed among specific DES. Second-generation were superior to first-generation DES in reducing stent thrombosis. (Clinical Outcomes After Primary Percutaneous Coronary Intervention [PCI] Using Contemporary Drug-Eluting Stent [DES]: Evidence From the Individual Patient Data Network Meta-Analysis; CRD42018104053)."}