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Minerva Cardioangiologica 2013 April;61(2):201-9


language: English

Outcome of ST-elevation myocardial infarction versus non-ST-elevation acute coronary syndrome treated with titanium-nitride-oxide-coated versus everolimus-eluting stents: insights from the BASE-ACS trial

Romppanen H. 1, 2, Nammas W. 3, Kervinen K. 1, Mikkelsson J. 3, Pietilä M. 4, Lalmand J. 5, Rivero-Crespo F. 6, Pentikäinen M. 7, Tedjokusumo P. 8, Karjalainen P. P. 3

1 Division of Cardiology, Department of Internal Medicine, University of Oulu, Oulu, Finland; 2 Heart Center, Kuopio University Hospital, Kuopio, Finland; 3 Heart Center, Satakunta Central Hospital, Pori, Finland; 4 Department of Medicine, Turku University Hospital, Turku, Finland; 5 CHU de Charleroi, Charleroi, Belgium; 6 Interventional Cardiology Section, La Princesa University Hospital, Madrid, Spain; 7 Department of Cardiology, Helsinki University Central Hospital, Helsinki, Finland; 8 Department of Cardiology and Vascular Medicine, Dr. Hasan Sadikin Hospital, Bandung, Indonesia


Aim: The BASE-ACS trial demonstrated an outcome of titanium-nitride-oxide-coated bioactive stents (BAS) that was statistically non-inferior to that of everolimus-eluting stents (EES) at 12-month follow-up, in patients presenting with acute coronary syndrome (ACS) who underwent early percutaneous coronary intervention (PCI). We explored a post-hoc analysis of the 12-month outcome of the BASE-ACS trial in the subgroup of patients with ST-elevation myocardial infarction (STEMI) versus non-ST-elevation ACS (non-STEACS).
Methods: A total of 827 patients with ACS (321 STEMI) were randomly assigned to receive either BAS or EES. The primary endpoint was a composite of cardiac death, non-fatal myocardial infarction (MI) and ischemia-driven target lesion revascularization (TLR) at 12-month follow-up.
Results: The 12-month cumulative incidence of the primary endpoint was similar between the two subgroups (9% versus 9.5%, in STEMI versus non-STEACS patients respectively, P=0.90). The 12-month rate of cardiac death was significantly higher in the STEMI subgroup as compared with the non-STEACS subgroup (2.8 versus 0.6%, respectively, P=0.01). However, the rates of non-fatal MI, ischemia-driven TLR, definite stent thrombosis, and non-cardiac death were all statistically matched between the two subgroups (P>0.05 for all).
Conclusion: In the current post-hoc analysis of the BASE-ACS trial based on the infarction type, the 12-month outcome of patients who underwent early PCI for ACS was slightly worse in the setting of STEMI as compared with non-STEACS, as reflected by a significantly higher rate of cardiac death.

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