Document Detail


Drug-eluting stents versus bare-metal stents in acute ST-segment elevation myocardial infarction. a single-center experience with long-term follow up.
MedLine Citation:
PMID:  20351384     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare the efficacy and safety of drugeluting stents (DES) vs. bare-metal stents (BMS) in patients with acute ST-segment-elevation myocardial infarction (STEMI). BACKGROUND: DES effectively reduce restenosis in elective percutaneous coronary intervention. Limited data are available about the use of DES in patients with STEMI. METHODS: 453 consecutive patients who presented with STEMI between July 2003 and May 2006 were studied. The procedural characteristics, 30-day, 12-, 18- and 26-month outcomes of 277 patients treated with DES were compared with 176 patients treated with BMS. RESULTS: At 26-month follow up, DES therapy was associated with a significant decrease in major adverse cardiac events (MACE) (relative risk [RR] -35%; p = 0.01) and target lesion revascularization [TLR], RR -64%; p = 0.009). The DES group included more diabetic patients (20% vs. 9%; p < 0.001), and the stents were longer (22 +/- 0.28 mm vs. 19.4 +/- 0.36 mm; p < 0.001) and smaller (diameter: 2.9 +/- 0.02 mm vs. 3.1 +/- 0.02 mm; p < 0.001). The rate of stent thrombosis was similar and the prolonged combined antiplatelet therapy was an independent factor predicting a protective effect on MACE. CONCLUSIONS: DES reduce the incidence of TLR and MACE in patients with STEMI without evidence of additional risks at 2-year follow up. DES therapy was associated with more complex interventional techniques, which yielded similar procedural results and clinical outcomes that may be influenced by prolonged combined antiplatelet therapy.
Authors:
Cataldo Palmieri; Marcello Ravani; Giuseppe Trianni; Jacopo Gianetti; Marco Vaghetti; Antonio Rizza; Umberto Paradossi; Arton Beqiri; Sergio Berti
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-08-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-8     Citation Subset:  IM    
Affiliation:
Gabriele Monasterio Foundation, and Institute of Clinical Physiology CNR, National Research Council G Pasquinucci Hospital, Massa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / instrumentation*
Antibiotics, Antineoplastic / administration & dosage*
Antineoplastic Agents, Phytogenic / administration & dosage*
Cohort Studies
Coronary Angiography
Drug-Eluting Stents*
Female
Follow-Up Studies
Humans
Male
Metals*
Middle Aged
Myocardial Infarction / therapy*
Paclitaxel / administration & dosage*
Prosthesis Design
Recurrence
Retrospective Studies
Sirolimus / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibiotics, Antineoplastic; 0/Antineoplastic Agents, Phytogenic; 0/Metals; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comments/Corrections
Comment In:
J Invasive Cardiol. 2010 Apr;22(4):159-60   [PMID:  20351385 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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