Abstract 20769: Drug-Eluting Stents versus Bare-Metal Stents in Patients with Acute Myocardial Infarction Undergoing Single-Vessel Percutaneous Coronary Intervention in Large Coronary Arteries: 1-Year Clinical Follow-Up
Background: Effectiveness of drug-eluting stents (DES) versus bare-metal stents (BMS) in large vessels remains controversial, particularly in patients with acute coronary syndrome.
Objective: This study compared clinical outcomes of DES versus BMS in large coronary arteries (≥3.5 mm) in patients with acute myocardial infarction (MI).
Methods: A total of 985 patients who underwent single-vessel percutaneous coronary intervention (PCI) with a stent ≥3.5 mm in diameter and <25 mm in length were divided into 2 groups (DES group: n=841 and BMS group: n=144). Clinical outcomes at 30 days, 6 and 12 months were compared. Propensity score analysis with logistic regression was used to control for confounders.
Results: In-hospital outcome was similar between the groups. At six months, the rates of death and MI were not different. However, the rates of target-lesion revascularization (TLR) and target-vessel revascularization (TVR) were significantly higher in patients who underwent BMS implantation (5.6 vs. 1.7%, p=0.021 and 5.6 vs. 2.2%, p=0.032). The rates of composite major adverse cardiac events (MACE) were also higher in the BMS group (11.9 vs. 3.4%, p=0.025). At 12 months, death/MI rates were similar but the rates of TLR and TVR remained higher in the BMS (5.9 vs. 2.5%, p=0.032 and 5.9 vs. 3.1%, p=0.041). The 12-month composite MACE rates were also higher (but not statistically significant) in the BMS group (12.7 vs. 6.1%, p=0.244).
Conclusions: The use of DES in patients with acute MI undergoing PCI in large coronary arteries was associated with higher TLR/TVR-free survival without increased rates of death/MI during one-year clinical follow-up.
- © 2010 by American Heart Association, Inc.