{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T20:17:23Z","timestamp":1770841043722,"version":"3.50.1"},"reference-count":13,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec><jats:title>Importance<\/jats:title><jats:p>Titanium-nitride-oxide (TiNO)\u2013coated stents show faster strut coverage compared with drug-eluting stents without excessive intimal-hyperplasia observed in bare metal stents. It is important to study long-term clinical outcomes after treatment of patients with an acute coronary syndrome (ACS) by TiNO-coated stents, which are neither drug-eluting stents nor bare metal stents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the rate of main composite outcome of cardiac death, myocardial infarction (MI), or ischemia-driven target lesion revascularization at 5 years in patients with ACS randomized to receive either a TiNO-coated stent or a third-generation everolimus-eluting stent (EES).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This multicenter, randomized, controlled, open-label trial was conducted in 12 clinical sites in 5 European countries and enrolled patients from January 2014 to August 2016. Patients presenting with ACS (ST-segment elevation MI, non\u2013ST-segment elevation MI, and unstable angina) with at least 1 de novo lesion were randomized to receive either a TiNO-coated stent or an EES. The present report analyzes the long-term follow-up for the main composite outcome and its individual components. Analysis took place between November 2022 to March 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome<\/jats:title><jats:p>The primary end point was a composite of cardiac death, MI, or target lesion revascularization at 12-month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1491 patients with ACS were randomly assigned to receive either TiNO-coated stents (989 [66.3%]) or EES (502 [33.7%]). The mean (SD) age was 62.7\u2009(10.8) years, and 363 (24.3%) were female. At 5 years, the main composite outcome events occurred in 111 patients (11.2%) in the TiNO group vs 60 patients (12%) in the EES group (hazard ratio [HR], 0.94; 95% CI, 0.69-1.28; <jats:italic>P<\/jats:italic>\u2009=\u2009.69). The rate of cardiac death was 0.9% (9 of 989) vs 3.0% (15 of 502) (HR, 0.30; 95% CI, 0.13-0.69; <jats:italic>P<\/jats:italic>\u2009=\u2009.005), the rate of MI was 4.6% (45 of 989) vs 7.0% (35 of 502) (HR, 0.64; 95% CI, 0.41-0.99; <jats:italic>P<\/jats:italic>\u2009=\u2009.049), the rate of stent thrombosis was 1.2% (12 of 989) vs 2.8% (14 of 502) (HR, 0.43; 95% CI, 0.20-0.93; <jats:italic>P<\/jats:italic>\u2009=\u2009.034), and the rate of target lesion revascularization was 7.4% (73 of 989) vs 6.4% (32 of 502) (HR, 1.16; 95% CI, 0.77-1.76; <jats:italic>P<\/jats:italic>\u2009=\u2009.47) in the TiNO-coated stent arm and in the EES arm, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and relevance<\/jats:title><jats:p>In this study, patients with ACS had a main composite outcome that was not different 5 years after TiNO-coated stent or EES.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02049229\">NCT02049229<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2023.1373","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T07:30:35Z","timestamp":1684481435000},"page":"703","source":"Crossref","is-referenced-by-count":11,"title":["Titanium-Nitride-Oxide\u2013Coated vs Everolimus-Eluting Stents in Acute Coronary Syndrome"],"prefix":"10.1001","volume":"8","author":[{"given":"Frederic","family":"Bouisset","sequence":"first","affiliation":[{"name":"Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium"},{"name":"Departement of Cardiology, Toulouse University Hospital, Toulouse, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jussi","family":"Sia","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokkola Central Hospital, Kokkola, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Mizukami","sequence":"additional","affiliation":[{"name":"Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium"},{"name":"Division of Clinical Pharmacology, Department of Pharmacology, Showa University, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasi P.","family":"Karjalainen","sequence":"additional","affiliation":[{"name":"Heart and Lung Center, Helsinki University and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pim A. 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