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BASKET-PROVE: DES improves over BMS in non-ST-segment elevation ACS
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Sirolimus-eluting and everolimus-eluting stents, separately and combined, yielded improvements in morbidity and mortality compared with bare-metal stents in a cohort of patients with non-ST-segment elevation ACS, according to recent findings.
The researchers noted that clinical guidelines do not yet recommend DES in non-ST-segment elevation ACS.
Protocols for the BASKET-PROVE trial called for a comparison of three stents: the first-generation Cypher Select sirolimus-eluting stent (Cordis, Johnson & Johnson), the second-generation Xience V everolimus-eluting stent (Abbott Vascular) and the Vision cobalt-chromium BMS (Abbott Vascular). The current a priori planned post-hoc analysis included 754 with patients NSTE-ACS patients.
The combined 2-year rate of CV death or non-fatal MI served as the primary outcome measure. The two components of the primary endpoint along with clinically indicated target vessel revascularization and stent thrombosis were the secondary endpoints.
Individuals in the sirolimus-eluting stent group had lower 2-year rates of the primary endpoint than those in the BMS group (HR=0.31; CI, 0.11-0.90). A similar trend was reported for the everolimus-eluting stent compared with the BMS (HR=0.74; CI, 0.44-1.24).
For the 2-year TVR outcome, a lower risk was reported in the sirolimus group (HR=0.58; CI, 0.29-1.15) and in the everolimus group (HR=0.52; CI, 0.34-0.78) than in the BMS group.
A combined comparison of sirolimus- and everolimus-eluting stents with BMS demonstrated that the drug-eluting devices yielded significant reductions in CV death, MI and TVR.
The researchers concluded that the findings suggest DES improves both efficacy and safety compared with BMS, and provide support for the use of DES in patients with non-ST-segment elevation ACS.
Disclosure: The researchers report no relevant financial disclosures.
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