Key result
Implantation of a TITANOX stent significantly reduced the composite of MI, target lesion revascularization, or cardiac death compared with a paclitaxel-eluting stent at 2 years (11.2% vs 21.8%; P=0.004).
Why the study?
Does a titanium-nitride-oxide-coated stent reduce the composite of MI, target lesion revascularization, or cardiac death compared to a paclitaxel-eluting stent in patients with acute myocardial infarction undergoing percutaneous coronary intervention?
RCT (n=425)
Does a titanium-nitride-oxide-coated stent reduce the composite of MI, target lesion revascularization, or cardiac death compared to a paclitaxel-eluting stent in patients with acute myocardial infarction undergoing percutaneous coronary intervention?
Hazard Ratio: 2.2 (95% CI 1.3–3.8)
Absolute Event Rate: 11.2% vs 21.8%
p-value: p=0.004
Titanium-nitride-oxide-coated stents demonstrated superior 2-year clinical outcomes, including reduced MI, cardiac death, and stent thrombosis, compared to paclitaxel-eluting stents in patients with acute MI.
Supports TITANOX over paclitaxel-eluting stents in acute MI PCI; extends randomized evidence for titanium-nitride-oxide coatings.
BACKGROUND AND AIMS: The aim of this study was to evaluate the long-term effects of the titanium-nitride-oxide-coated (TITANOX) stent and the paclitaxel-eluting stent (PES) in patients who had undergone a percutaneous coronary intervention for acute myocardial infarction (MI). METHODS AND RESULTS: The TITAX-AMI trial randomly assigned 425 patients with MI to receive either a TITANOX stent or a PES. The primary end-point was a composite of MI, target lesion revascularization, or death from cardiac causes. At 12 months, there was no significant difference between patients receiving TITANOX stent or PES in the rate of primary end-point (10.3% versus 12.8%, P=0.5). After 2 years of follow-up, a significantly lower rate of primary end-point was observed in the TITANOX stent group compared with the PES group (11.2% versus 21.8%, HR 2.2, 95% confidence interval (CI) 1.3-3.8, P=0.004). This difference was driven by a reduced rate of MI (5.1% versus 15.6%, P<0.001) and cardiac death (0.9% versus 4.7%, P=0.02) in favour of the TITANOX stent. Definite stent thrombosis occurred in 0.5% and 6.2% of the patients (P=0.001), respectively. CONCLUSIONS: The implantation of a TITANOX stent resulted in better clinical outcome compared with a PES during 2 years of follow-up among patients treated for acute MI.
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Karjalainen et al. (2009) conducted an RCT in Acute myocardial infarction (n=425). Titanium-nitride-oxide-coated (TITANOX) stent vs. Paclitaxel-eluting stent (PES) was evaluated on Composite of MI, target lesion revascularization, or death from cardiac causes (HR 2.2, 95% CI 1.3-3.8, p=0.004). Implantation of a TITANOX stent significantly reduced the composite of MI, target lesion revascularization, or cardiac death compared with a paclitaxel-eluting stent at 2 years (11.2% vs 21.8%; P=0.004).
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