Sirolimus-eluting stents compared with standard stents in the treatment of patients with primary angioplasty.
BACKGROUND
Sirolimus-eluting stents have been shown to decrease restenosis and reintervention as compared with standard stents. We evaluated the use of sirolimus-eluting stents in primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation.


METHODS
We randomly assigned 120 patients to compare sirolimus-eluting stents with uncoated stents in primary percutaneous coronary intervention for acute myocardial infarction with ST-segment elevation. The primary end point was composite: death from cardiac causes, recurrent myocardial infarction, or target-lesion revascularization after 360 days.


RESULTS
The rate of the primary end point was 6.7% in the sirolimus-eluting stent and 11% in the bare-metal stent group (relative risk 1.75, 95% CI 0.47-6.57, P = .402). The survival free from target-vessel failure showed a higher trend in the sirolimus-eluting stent group than in the bare-metal stent group (0.0% vs 5.7%, P = .064). There was no significant difference between the 2 groups in the rate of death (5% and 3.6%, respectively; P = .736), reinfarction (1.7% and 1.8%, respectively; P = .940), or stent thrombosis (3.4% and 1.8%, respectively; P = .621).


CONCLUSIONS
Among selected patients with acute myocardial infarction and ST-segment elevation, the use of sirolimus-eluting stents shows a trend to reduce the rate of target-vessel revascularization in comparison with bare-metal stent.
Díaz de la Llera
Luis-S
LS
Hemodynamics and Interventional Cardiology Unit, University Hospital Virgen del Rocio, Seville, Spain. luissalvadordiaz@hotmail.com
Ballesteros
Sara
S
Nevado
Jaime
J
Fernández
Mónica
M
Villa
Manuel
M
Sánchez
Angel
A
Retegui
Gabriel
G
García
Dolores
D
Martínez
Angel
A
D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon; D003692:Delayed-Action Preparations; D018572:Disease-Free Survival; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000145:classification*; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; D020123:Sirolimus