Published Online
on October 13, 2003

A more recent version of this article appeared on October 21, 2003

This Article Full Text (PDF) All Versions of this Article: 108/16/1927    most recent 01.CIR.0000096053.87580.CDv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Saia, F. Articles by Serruys, P. W. Search for Related Content PubMed PubMed Citation Articles by Saia, F. Articles by Serruys, P. W. Related Collections Restenosis Catheter-based coronary interventions: stents Acute myocardial infarction

Submitted on June 30, 2003
Revised on September 2, 2003
Accepted on September 2, 2003

Sirolimus-Eluting Stent Implantation in ST-Elevation Acute Myocardial Infarction. A Clinical and Angiographic Study

Francesco Saia MD, Pedro A. Lemos MD, Chi-Hang Lee MD, Chourmouzios A. Arampatzis MD, Angela Hoye MB ChB, MRCP, Muzaffer Degertekin MD, Kengo Tanabe MD, Georgios Sianos MD, PhD, Pieter C. Smits MD, PhD, Eugene McFadden MB ChB, MRCPI, Sjoerd H. Hofma MD, Willem J. van der Giessen MD, PhD, Pim J. de Feyter MD, PhD, Ron T. van Domburg PhD, and Patrick W. Serruys MD, PhD^*

From the Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.

^* To whom correspondence should be addressed. E-mail: p.w.j.c.serruys{at}erasmusmc.nl.

Background--Sirolimus-eluting stents (SES) have recently been proven to reduce restenosis and reintervention compared with bare stents. Safety and effectiveness of SES in acute myocardial infarction remain unknown.

Methods and Results--Since April 16, 2002, a policy of routine SES implantation has been instituted in our hospital, with no clinical or anatomic restrictions, as part of the RESEARCH (Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital) registry. During 6 months of enrollment, 96 patients with ST-elevation acute myocardial infarction underwent percutaneous recanalization and SES implantation; these patients comprise the study population. The incidence of major adverse cardiac events (death, nonfatal myocardial infarction, reintervention) was evaluated. Six-month angiographic follow-up was scheduled per protocol. At baseline, diabetes mellitus was present in 12.5% and multivessel disease in 46.9%. Primary angioplasty was performed in 89 patients (92.7%). Infarct location was anterior in 41 (42.7%) of the cases, and 12 patients (12.5%) had cardiogenic shock. Postprocedural TIMI-3 flow was achieved in 93.3% of the cases. In-hospital mortality was 6.2%. One patient (1.1%) had reinfarction and target lesion reintervention the first day as a result of distal dissection and acute vessel occlusion. During follow-up (mean follow-up of 218±75 days), 1 patient died (1.1%), no patient had recurrent myocardial infarction, and there were no additional reinterventions. No early or late stent thromboses were documented. At angiographic follow-up (70%), late loss was -0.04±0.25, and no patient presented angiographic restenosis.

Conclusions--In this study, sirolimus-eluting stent implantation for patients with ST-elevation acute myocardial infarction was safe without documented angiographic restenosis at 6 months.

Key words: myocardial infarction • drugs • stents • restenosis

This article has been cited by other articles:

				T. Kubo, T. Imanishi, H. Kitabata, A. Kuroi, S. Ueno, T. Yamano, T. Tanimoto, Y. Matsuo, T. Masho, S. Takarada, et al. Comparison of vascular response after sirolimus-eluting stent implantation between patients with unstable and stable angina pectoris a serial optical coherence tomography study. J. Am. Coll. Cardiol. Img., July 1, 2008; 1(4): 475 - 484. [Abstract] [Full Text] [PDF]

				G. Sianos, M. I. Papafaklis, J. Daemen, S. Vaina, C. A. van Mieghem, R. T. van Domburg, L. K. Michalis, and P. W. Serruys Angiographic Stent Thrombosis After Routine Use of Drug-Eluting Stents in ST-Segment Elevation Myocardial Infarction: The Importance of Thrombus Burden J. Am. Coll. Cardiol., August 14, 2007; 50(7): 573 - 583. [Abstract] [Full Text] [PDF]

				M. Menichelli, A. Parma, E. Pucci, R. Fiorilli, F. De Felice, M. Nazzaro, A. Giulivi, D. Alborino, A. Azzellino, and R. Violini Randomized Trial of Sirolimus-Eluting Stent Versus Bare-Metal Stent in Acute Myocardial Infarction (SESAMI) J. Am. Coll. Cardiol., May 15, 2007; 49(19): 1924 - 1930. [Abstract] [Full Text] [PDF]

				C. Spaulding, P. Henry, E. Teiger, K. Beatt, E. Bramucci, D. Carrie, M. S. Slama, B. Merkely, A. Erglis, M. Margheri, et al. Sirolimus-Eluting versus Uncoated Stents in Acute Myocardial Infarction N. Engl. J. Med., September 14, 2006; 355(11): 1093 - 1104. [Abstract] [Full Text] [PDF]

				G. J. Laarman, M. J. Suttorp, M. T. Dirksen, L. van Heerebeek, F. Kiemeneij, T. Slagboom, L. R. van der Wieken, J. G.P. Tijssen, B. J. Rensing, and M. Patterson Paclitaxel-Eluting versus Uncoated Stents in Primary Percutaneous Coronary Intervention N. Engl. J. Med., September 14, 2006; 355(11): 1105 - 1113. [Abstract] [Full Text] [PDF]

				W. Kim, M. H. Jeong, K. H. Kim, I. S. Sohn, Y. J. Hong, H. W. Park, J. H. Kim, Y. K. Ahn, J. G. Cho, J. C. Park, et al. The Clinical Results of a Platelet Glycoprotein IIb/IIIa Receptor Blocker (Abciximab: ReoPro)-Coated Stent in Acute Myocardial Infarction J. Am. Coll. Cardiol., March 7, 2006; 47(5): 933 - 938. [Abstract] [Full Text] [PDF]

				S. G. Raja Drug-Eluting Stents and the Future of Coronary Artery Bypass Surgery: Facts and Fiction Ann. Thorac. Surg., March 1, 2006; 81(3): 1162 - 1171. [Abstract] [Full Text] [PDF]

				W. Alvarez Jr and N. K. Kapur Drug Eluting Stent Technology: A Paradigm Shift in the Treatment and Prevention of Restenosis Journal of Pharmacy Practice, December 1, 2005; 18(6): 461 - 478. [Abstract] [PDF]

				P. S. Monraats, N. M. M. Pires, A. Schepers, W. R. P. Agema, L. S. M. Boesten, M. R. de Vries, A. H. Zwinderman, M. P. M. de Maat, P. A. F. M. Doevendans, R. J. de Winter, et al. Tumor necrosis factor-{alpha} plays an important role in restenosis development FASEB J, December 1, 2005; 19(14): 1998 - 2004. [Abstract] [Full Text] [PDF]

				D. M Safley and S. P Marso Diabetes and percutaneous coronary intervention in the setting of an acute coronary syndrome Diabetes and Vascular Disease Research, October 1, 2005; 2(3): 128 - 135. [Abstract] [PDF]

				M. Valgimigli, G. Percoco, G. Cicchitelli, G. Campo, E. Gardini, L. Pellegrino, P. Malagutti, C. Giretti, and R. Ferrari New and old strategies to afford the liberal use of drug-eluting stents in real-life scenarios Eur. Heart J. Suppl., October 1, 2005; 7(suppl_K): K31 - K35. [Abstract] [Full Text] [PDF]

				S R Dixon Infarct angioplasty: beyond stents and glycoprotein IIb/IIIa inhibitors Heart, June 1, 2005; 91(suppl_3): iii2 - iii6. [Full Text] [PDF]

				M. Valgimigli, G. Percoco, P. Malagutti, G. Campo, F. Ferrari, D. Barbieri, G. Cicchitelli, E. P. McFadden, F. Merlini, L. Ansani, et al. Tirofiban and Sirolimus-Eluting Stent vs Abciximab and Bare-Metal Stent for Acute Myocardial Infarction: A Randomized Trial JAMA, May 4, 2005; 293(17): 2109 - 2117. [Abstract] [Full Text] [PDF]

				J. G. Byrne, M. Leacche, D. Unic, J. D. Rawn, D. I. Simon, C. D. Rogers, and L. H. Cohn Staged initial percutaneous coronary intervention followed by valve surgery ("hybrid approach") for patients with complex coronary and valve disease J. Am. Coll. Cardiol., January 4, 2005; 45(1): 14 - 18. [Abstract] [Full Text] [PDF]

				W. W. O'Neill and S. R. Dixon The year in interventional cardiology J. Am. Coll. Cardiol., March 3, 2004; 43(5): 875 - 890. [Full Text] [PDF]

				P. A. Lemos, F. Saia, S. H. Hofma, J. Daemen, A. T. L. Ong, C. A. Arampatzis, A. Hoye, E. McFadden, G. Sianos, P. C. Smits, et al. Short- and long-term clinical benefit of sirolimus-eluting stents compared to conventional bare stents for patients with acute myocardial infarction J. Am. Coll. Cardiol., February 18, 2004; 43(4): 704 - 708. [Abstract] [Full Text] [PDF]

				D. P. Faxon Bringing Reality to Drug-Eluting Stents Circulation, January 20, 2004; 109(2): 140 - 142. [Full Text] [PDF]

				Sirolimus-Eluting Stents After MI Journal Watch Cardiology, December 12, 2003; 2003(1212): 3 - 3. [Full Text]