title: Meta-analysis of randomized trials on drug-eluting stents vs. bare-metal stents in patients with acute myocardial infarction.
abstract: OBJECTIVE
  To compare the efficacy and safety of drug-eluting stents vs. bare-metal stents in patients with acute ST-segment elevation myocardial infarction.
  
  
  RESULTS
  We performed a meta-analysis of eight randomized trials comparing drug-eluting stents (sirolimus-eluting or paclitaxel-eluting stents) with bare-metal stents in 2786 patients with acute ST-segment elevation myocardial infarction. All patients were followed up for a mean of 12.0-24.2 months. Individual data were available for seven trials with 2476 patients. The primary efficacy endpoint was the need for reintervention (target lesion revascularization). The primary safety endpoint was stent thrombosis. Other outcomes of interest were death and recurrent myocardial infarction. Drug-eluting stents significantly reduced the risk of reintervention, hazard ratio of 0.38 (95% CI, 0.29-0.50), P < 0.001. The overall risk of stent thrombosis: hazard ratio of 0.80 (95% CI, 0.46-1.39), P = 0.43; death: hazard ratio of 0.76 (95% CI, 0.53-1.10), P = 0.14; and recurrent myocardial infarction: hazard ratio of 0.72 (95% CI, 0.48-1.08, P = 0.11) was not significantly different for patients receiving drug-eluting stents vs. bare-metal stents.
  
  
  CONCLUSIONS
  The use of drug-eluting stents in patients with acute ST-segment elevation myocardial infarction is safe and improves clinical outcomes by reducing the risk of reintervention compared with bare-metal stents.
authors: Deutsches Herzzentrum, Technische Universität, Lazarettstr.36, Munich 80636, Germany. kastrati@dhm.mhn.de
authors: Adnan
authors: A
authors: Kastrati
authors: Alban
authors: A
authors: Dibra
authors: Christian
authors: C
authors: Spaulding
authors: Gerrit J
authors: GJ
authors: Laarman
authors: Maurizio
authors: M
authors: Menichelli
authors: Marco
authors: M
authors: Valgimigli
authors: Emilio
authors: E
authors: Di Lorenzo
authors: Christoph
authors: C
authors: Kaiser
authors: Ilkka
authors: I
authors: Tierala
authors: Julinda
authors: J
authors: Mehilli
authors: Melchior
authors: M
authors: Seyfarth
authors: Olivier
authors: O
authors: Varenne
authors: Maurits T
authors: MT
authors: Dirksen
authors: Gianfranco
authors: G
authors: Percoco
authors: Attilio
authors: A
authors: Varricchio
authors: Undine
authors: U
authors: Pittl
authors: Mikko
authors: M
authors: Syvänne
authors: Maarten J
authors: MJ
authors: Suttorp
authors: Roberto
authors: R
authors: Violini
authors: Albert
authors: A
authors: Schömig
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000401:mortality; D023903:Coronary Restenosis / Q000401:mortality / Q000517:prevention & control; D054855:Drug-Eluting Stents; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome