Document Detail

Long-term outcome after drug eluting stenting in patients with ST-segment elevation myocardial infarction: data from the REAL registry.
MedLine Citation:
PMID:  19056134     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The long-term safety and efficacy of drug eluting stents (DES) implanted during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is unclear. The purpose of this study was to compare the long-term outcome of STEMI patients undergoing primary PCI with DES vs. bare metal stent (BMS) implantation. METHODS: In the present analysis 4764 patients were enrolled (706, 15%, received DES). We assessed the cumulative incidence of major adverse cardiac events (MACE) and stent thrombosis (ST). RESULTS: Overall, no significant difference emerged for the rates of death and reinfarction. DES implantation was associated to a reduction of target vessel revascularization (TVR) (HR 0.65, 95%CI 0.47-0.91; p=0.01), leading to a MACE reduction (HR 0.7, 95%CI 0.56-0.86; p<0.01). In particular, during the first 2 years we observed less adverse events in the DES group, mainly because of a lower TVR rate (TVR: HR 0.56, 95%CI 0.37-0.83, p<0.01; MACE: HR 0.71, 95%CI 0.54-0.94, p=0.01). On the contrary, during the third year, adverse events tended to be higher in the DES group. ST did not differ between DES and BMS groups (p=0.6). No differences were observed between sirolimus eluting stents and paclitaxel eluting stents. CONCLUSIONS: DES implantation during primary PCI is safe and associated with a significant TVR and MACE reduction in the first two years, whereas a trend to have more adverse events in the third year is observed. More data about long-term follow-up are needed to better evaluate both safety and efficacy of DES in the setting of STEMI.
Gianluca Campo; Francesco Saia; Gianfranco Percoco; Antonio Manari; Andrea Santarelli; Luigi Vignali; Elisabetta Varani; Alberto Benassi; Pietro Sangiorgio; Fabio Tarantino; Paolo Magnavacchi; Rossana De Palma; Paolo Guastaroba; Antonio Marzocchi
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Publication Detail:
Type:  Journal Article     Date:  2008-12-03
Journal Detail:
Title:  International journal of cardiology     Volume:  140     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  154-60     Citation Subset:  IM    
Copyright Information:
Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
Unità Operativa di Cardiologia, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Antineoplastic Agents, Phytogenic / therapeutic use
Coronary Restenosis / epidemiology*
Coronary Thrombosis / epidemiology*
Drug-Eluting Stents / adverse effects,  statistics & numerical data*
Follow-Up Studies
Immunosuppressive Agents / therapeutic use
Middle Aged
Myocardial Infarction / diagnosis,  epidemiology*,  therapy*
Paclitaxel / therapeutic use
Registries / statistics & numerical data
Sirolimus / therapeutic use
Treatment Outcome
Reg. No./Substance:
0/Antineoplastic Agents, Phytogenic; 0/Immunosuppressive Agents; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus

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