Safety and efficacy with drug-eluting stent in ST-segment elevation and non-ST-segment elevation myocardial infarction

Abstract

Background: Drug-eluting stents (DES) have been shown to reduce the need for repeat revascularization compared with bare metal stents (BMS). However, there is little information regarding the safety and long-term efficacy of DES in patients with acute myocardial infarction (AMI). Hypothesis: The aim of this study was to evaluate the safety and efficacy of DES in patients with AMI. Methods: Data from 211 consecutive patients with AMI treated with DES were compared with those from 228 consecutive patients with AMI treated with BMS. All patients were treated within 7 days of symptom onset. The incidence of major adverse cardiovascular events ([MACE]: death, reinfarction, and target vessel revascularization) was evaluated at 30 days and 1 year. Results: Baseline clinical and angiographic characteristics were similar for both stent groups. However, patients who received DES had longer lesion lengths (23.0 ± 12.7 vs. 18.8 ± 10.6 mm, respectively; p < 0.001) and smaller reference diameters (2.97 ± 0.52 vs. 3.19 ± 0.63 mm, respectively, p < 0.001). At 30 days, the incidence rates of MACE (DES vs. BMS: 2.2 vs. 1.9%, p = 1.000) and stent thrombosis (BMS vs. DES: 0.9 vs. 1.7%; p = 0.434) did not differ significantly between the groups. At 1 year, patients with DES had a lower rate of MACE (BMS vs. DES: 14.0 vs. 6.6%; p = 0.011) primarily due to a lower target vessel revascularization rate (BMS vs. DES: 9.6 vs. 4.8%; p = 0.028). Conclusions: The DES appear to be superior to the BMS in reducing the risk of MACE in patients with AMI.