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[Long-term clinical and angiographic follow-up of drug-eluting stents in patients with ST-elevation acute myocardial infarction].

AbstractINTRODUCTION AND OBJECTIVES:
Drug-eluting stents (DES) have proven to be effective in reducing the rate of restenosis and have, therefore, been incorporated into the treatment of patients with ST-elevation acute myocardial infarction (STEMI). The aim of this study was to investigate long-term clinical and angiographic outcomes following the use of DESs in patients with STEMI.
METHODS:
A prospective study involving clinical and angiographic follow-up was performed in 81 patients with STEMI who underwent percutaneous coronary intervention including DES implantation. This group was compared with 82 patients with similar characteristics who were treated with bare-metal stents (BMS) in an earlier period.
RESULTS:
At one year, there was no significant difference between the groups in the mortality (2.5% in the DES group vs 7.3% in the BMS group; P=.15) or reinfarction rate (4.8% in the DES group vs. 4.8% in the BMS group; P=.98). The target lesion revascularization rate was significantly lower in the DES group (8.6% vs 23.2% in the BMS group; P=.001), as was the restenosis rate (13.8% vs. 30.9% in the BMS group; P=.02). Acute or subacute stent thrombosis was diagnosed in five patients (3 with a DES and 2 with a BMS; P=.64), and one late stent thrombosis was detected after a year, in a sirolimus-eluting stent.
CONCLUSIONS:
Implantation of a DES in patients with STEMI did not result in a reduction in either the mortality or reinfarction rate at 1 year compared with BMS implantation. However, there were reductions in the rates of restenosis and target lesion revascularization. The incidence of thrombosis was similar with the two types of stent.
AuthorsAna M Planas-Del Viejo, Francisco Pomar-Domingo, Juan V Vilar-Herrero, Victoria Jacas-Osborn, Mercedes Nadal-Barangé, Emilio Pérez-Fernández
JournalRevista española de cardiología (Rev Esp Cardiol) Vol. 61 Issue 4 Pg. 360-8 (Apr 2008) ISSN: 1579-2242 [Electronic] Spain
Vernacular TitleResultados clínicos y angiográficos tardíos de stents liberadores de fármacos en pacientes con infarto agudo de miocardio con elevación del ST.
PMID18405516 (Publication Type: English Abstract, Journal Article)
Topics
  • Coronary Angiography
  • Cross-Sectional Studies
  • Drug-Eluting Stents
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction (physiopathology, radiography, surgery)
  • Prospective Studies
  • Time Factors

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