title: [Promising efficacy of the sirolimus-eluting stent in patients with acute myocardial infarction].
abstract: OBJECTIVE
  This study investigated the safety and efficacy of sirolimus-eluting stents (SESs) on early and late outcomes in patients with acute myocardial infarction.
  
  
  METHODS
  A series of 100 consecutive patients (September 2004 to November 2005)with acute myocardial infarction undergoing primary stenting using SES ptember 24 hr) was compared with 100 consecutive patients (September 2003 to August 2004) treated with bare metal stent (BMS). The frequency of major adverse cardiac events (MACE) and stent thrombosis, and status of ticlopidine administration were assessed at 270 days.
  
  
  RESULTS
  The rates of premature discontinuation of ticlopidine (SES group <3 months: 11%, BMS group <1 month: 11%, p = NS) and stent thrombosis (SES group: 1%, BMS group: 0%, p = NS) were similar in the two groups. At follow-up, restenosis rate and target vessel revascularization rate were lower in the SES group(4% vs 19%, p < 0.001 and 4% vs 10%, p = 0.149, respectively). Furthermore, the occurrence of MACE at 270 days was significantly less frequent in the SES group compared with the BMS group (6% vs. 17%, p = 0.038). Multivariate analysis showed SES use tended to predict 270-day MACE (hazard ratio 0.37, 95% confidence interval 0.14-1.02, p = 0.055). Culprit lesion located in the left main trunk was identified as an independent predictor of 270-day MACE (hazard ratio 5.43, 95% confidence interval 1.07-27.59, p = 0.041).
  
  
  CONCLUSIONS
  The use of a SES was not associated with increased risk of stent thrombosis compared with a BMS. With lower rates of restenosis and subsequent target vessel revascularization, SES placement could provide superior outcomes in patients with acute myocardial infarction.
authors.affiliation: Division of Cardiology, Aichi Prefectural Cardiovascular and Respiratory Center, Aichi. gtomoko0922@yahoo.co.jp
authors.forename: Tomoko
authors.initials: T
authors.lastname: Gochi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Umeda
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshida
authors.forename: Hironobu
authors.initials: H
authors.lastname: Maekawa
authors.forename: Kosuke
authors.initials: K
authors.lastname: Watanabe
authors.forename: Taro
authors.initials: T
authors.lastname: Okada
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Katoh
authors.forename: Toru
authors.initials: T
authors.lastname: Asai
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Tani
authors.forename: Masaki
authors.initials: M
authors.lastname: Yokoya
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Murakami
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Matsushita
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Hiramitsu
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Masanori
authors.initials: M
authors.lastname: Nomura
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Morimoto
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D020123:Sirolimus