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

Abstract

INTRODUCTION 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.

• Authors: Ana M Planas-Del Viejo, Francisco Pomar-Domingo, Juan V Vilar-Herrero, Victoria Jacas-Osborn, Mercedes Nadal-Barangé, Emilio Pérez-Fernández
• Journal: Revista espanola de cardiologia (Rev Esp Cardiol) Vol. 61 Issue 4 Pg. 360-8 (Apr 2008) ISSN: 1579-2242 [Electronic] Spain
• Vernacular Title: Resultados clínicos y angiográficos tardíos de stents liberadores de fármacos en pacientes con infarto agudo de miocardio con elevación del ST.
• PMID: 18405516 (Publication Type: Journal Article)

Topics

• Coronary Angiography
• Cross-Sectional Studies
• Drug-Eluting Stents
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, physiopathology, surgery)
• Prospective Studies
• Time Factors