Abstract 2647: The MISSION! Intervention study: Prospective Randomized Trial to Evaluate the Efficacy and Safety of Drug-Eluting Stents versus Bare-Metal Stents for the Treatment of Acute Myocardial Infarction
Introduction The MISSION! Intervention Study is a randomized, single center study in 316 patients comparing a drug eluting stent and a non-coated stent in patients with STEMI refered for primary PCI.
Methods Patients with AMI (<9 hours) due to a de novo coronary artery lesion with a reference diameter of 2.25 to 3.75 mm. Either a sirolimus-eluting Cypher Select stent or a cobalt chromium Vision stent was implanted. The primary angiographic endpoint of the study is the in-lesion late loss at 9 months. Secondary endpoints include: target lesion revascularization rate at 12 months, and minimum lumen area (intracoronary ultrasound) at 9 months. All patients received abciximab during the procedure and aspirin and clopidogrel for 1 year after the procedure.
Preliminary results: Baseline clinical characteristics are: age 59 ± 12 yrs, male 78%, diabetes mellitus 10%, hypertension 29%, hyperlipidemia 20%, smoking 54%, family history of CAD 44%, previous PCI/CABG 3%, and previous myocardial infarction 4%. Target vessel: LAD 58%; RCA 28%; and LCX 14%. Stent length target lesion: 26 ± 12 mm. Number of stents implanted within the culprit lesion: 1.3 ± 0.6 mm. In-hospital outcome: procedural success 93% (alive and residual stenosis <30% and TIMI 3 flow), death 1.3%, non-target vessel revascularization 2.8%, target lesion revascularization 0%, stent thrombosis 0.6%. 30-days outcome: death 1.6%, myocardial infarction 1.3%, non-target vessel revascularization 3.2%, target vessel revascularization 1.6%, target lesion revascularization 0.6%, stent thrombosis 1.3%.
Conclusion The randomized MISSION! Intervention Study comparing a drug eluting stent and a cobalt chromium stent in patients with STEMI demonstrates excellent acute and 30 days preliminary results and low rates of target lesion revascularization and subacute stent thrombosis.