title: Sirolimus-eluting stents compared with standard stents in the treatment of patients with primary angioplasty.
abstract: 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.
authors.affiliation: Hemodynamics and Interventional Cardiology Unit, University Hospital Virgen del Rocio, Seville, Spain. luissalvadordiaz@hotmail.com
authors.forename: Luis-S
authors.initials: LS
authors.lastname: Díaz de la Llera
authors.forename: Sara
authors.initials: S
authors.lastname: Ballesteros
authors.forename: Jaime
authors.initials: J
authors.lastname: Nevado
authors.forename: Mónica
authors.initials: M
authors.lastname: Fernández
authors.forename: Manuel
authors.initials: M
authors.lastname: Villa
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez
authors.forename: Gabriel
authors.initials: G
authors.lastname: Retegui
authors.forename: Dolores
authors.initials: D
authors.lastname: García
authors.forename: Angel
authors.initials: A
authors.lastname: Martínez
mesh_terms: 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
chemical_list: D003692:Delayed-Action Preparations; D020123:Sirolimus