title: Long-term outcome of acute myocardial infarction patients treated with stents versus balloon angioplasty: results from randomized trials.
abstract: OBJECTIVE
  To examine the impact of primary stent implantation versus balloon angioplasty on long-term outcome (median 8 years) in 117 patients with ST-elevation myocardial infarction (STEMI) from randomized trials.
  
  
  METHODS
  Enrolled patients were those presenting with STEMI within 12 h of symptom onset. Patients were randomized to either Palmaz-Schatz stent implantation (N=25) or balloon angioplasty (N=23) between January and November 1996; or Palmaz-Schatz (N=26), or Cordis coil stent implantation (N=24) or balloon angioplasty (N=19) between February 1998 and March 1999.
  
  
  RESULTS
  Patients (67+/-11 years) arrived to the hospital within median 2.5 h of symptom onset with Killip 1/2/3/4 grade (72/19/7/2%, respectively). The culprit lesion was located in the left anterior descending (50%), right (39%), or left circumflex coronary artery (11%) with TIMI 0/1/2/3 flow (81/5/12/2%, respectively). Clinical/angiographic features were comparable between the 2 groups. During follow-up, there was a significant reduction in cardiac mortality in the stent group (5%) compared to the angioplasty group (17%, log-rank test p=0.04). In addition, the stent group had a lower target lesion revascularization rate (28% versus 52%, p=0.008), and a significantly lower major adverse cardiac event rate (37% versus 67%, p=0.005), than the angioplasty group.
  
  
  CONCLUSIONS
  Compared to balloon angioplasty, primary stenting resulted in a sustained beneficial effect on cardiac mortality at 8 years.
authors: Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, 1202-1 Yamazaki, Kamakura 247-8533, Japan. hdkaneda@gmail.com
authors: Hideaki
authors: H
authors: Kaneda
authors: Yoshitaka
authors: Y
authors: Hiroe
authors: Shinji
authors: S
authors: Tanaka
authors: Takaaki
authors: T
authors: Shiono
authors: Hideko
authors: H
authors: Inaba
authors: Yusuke
authors: Y
authors: Miyashita
authors: Saeko
authors: S
authors: Takahashi
authors: Yoshio
authors: Y
authors: Taketani
authors: Hiroshi
authors: H
authors: Domae
authors: Junya
authors: J
authors: Matsumi
authors: Shigeru
authors: S
authors: Saito
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome