title: A comparison of systematic stenting and conventional balloon angioplasty during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction. STENTIM-2 Investigators.
abstract: OBJECTIVE
  In a multicenter, randomized trial, systematic stenting using the Wiktor stent was compared to conventional balloon angioplasty with provisional stenting for the treatment of acute myocardial infarction (AMI).
  
  
  BACKGROUND
  Primary angioplasty in AMI is limited by in-hospital recurrent ischemia and a high restenosis rate.
  
  
  METHODS
  A total of 211 patients with AMI <12 h from symptom onset, with an occluded native coronary artery, were randomly assigned to systematic stenting (n = 101) or balloon angioplasty (n = 110). The primary end point was the binary six-month restenosis rate determined by core laboratory quantitative angiographic analysis.
  
  
  RESULTS
  Angiographic success (Thrombolysis in Myocardial Infarction [TIMI] flow grade 3 and residual diameter stenosis <50%) was achieved in 86% of the patients in the stent group and in 82.7% of those in the balloon angioplasty group (p = 0.5). Compared with the 3% cross-over in the stent group, cross-over to stenting was required in 36.4% of patients in the balloon angioplasty group (p = 0.0001). Six-month binary restenosis (> or = 50% residual stenosis) rates were 25.3% in the stent group and 39.6% in the balloon angioplasty group (p = 0.04). At six months, the event-free survival rates were 81.2% in the stent group and 72.7% in the balloon angioplasty group (p = 0.14), and the repeat revascularization rates were 16.8% and 26.4%, respectively (p = 0.1). At one year, the event-free survival rates were 80.2% in the stent group and 71.8% in the balloon angioplasty group (p = 0.16), and the repeat revascularization rates were 17.8% and 28.2%, respectively (p = 0.1).
  
  
  CONCLUSIONS
  In the setting of primary angioplasty for AMI, as compared with a strategy of conventional balloon angioplasty, systematic stenting using the Wiktor stent results in lower rates of angiographic restenosis.
authors.affiliation: CHU Tours, France. luc.maillard@med.univ-tours.fr
authors.forename: L
authors.initials: L
authors.lastname: Maillard
authors.forename: M
authors.initials: M
authors.lastname: Hamon
authors.forename: K
authors.initials: K
authors.lastname: Khalife
authors.forename: P G
authors.initials: PG
authors.lastname: Steg
authors.forename: F
authors.initials: F
authors.lastname: Beygui
authors.forename: J L
authors.initials: JL
authors.lastname: Guermonprez
authors.forename: C M
authors.initials: CM
authors.lastname: Spaulding
authors.forename: J M
authors.initials: JM
authors.lastname: Boulenc
authors.forename: J
authors.initials: J
authors.lastname: Lipiecki
authors.forename: A
authors.initials: A
authors.lastname: Lafont
authors.forename: P
authors.initials: P
authors.lastname: Brunel
authors.forename: G
authors.initials: G
authors.lastname: Grollier
authors.forename: R
authors.initials: R
authors.lastname: Koning
authors.forename: P
authors.initials: P
authors.lastname: Coste
authors.forename: X
authors.initials: X
authors.lastname: Favereau
authors.forename: B
authors.initials: B
authors.lastname: Lancelin
authors.forename: E
authors.initials: E
authors.lastname: Van Belle
authors.forename: P
authors.initials: P
authors.lastname: Serruys
authors.forename: J P
authors.initials: JP
authors.lastname: Monassier
authors.forename: P
authors.initials: P
authors.lastname: Raynaud
mesh_terms: D000800:Angioplasty, Balloon; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D015607:Stents