The efficacy of bare metal stent implantation for patients with acute myocardial infarction in the drug-eluting stent era.
BACKGROUND
Although several trials have demonstrated the safety of drug-eluting stent (DES) implantation for acute myocardial infarction (AMI) patients, care must be exercised when DES are implanted in AMI cases because of the risk of in-stent thrombosis or adverse side effects of antiplatelet agents. On the other hand, recently, there has been much improvement in bare metal stents (BMSs), and thus, the efficacy of BMS implantation should be reevaluated.


METHODS
We investigated the primary and long-term outcome of BMS implantation for AMI patients in the DES era (July 2004 to December 2006; n=97 [Group 1]) and compared the results with those in the pre-DES era (January 2002 to June 2004; n=81 [Group 2]), retrospectively.


RESULTS
The most frequently used BMS in Group 1 was the Driver stent (63.9%) and in Group 2 the Duraflex stent (44.4%). Stent length and diameter were not significantly different between Group 1 and Group 2. The rates of in-stent restenosis, and target lesion revascularization were lower in Group 1 than in Group 2. Restenosis frequently occurred in small vessel lesions and in lesions that had required more than 10atm fully to dilate the pre-dilatation balloon at the primary PCI.


CONCLUSIONS
Currently available BMSs are much more effective than old-type BMSs. However, DES implantation may be considered for small vessel diseases and lesions that need high pressure to dilate.
Department of Cardiovascular Center Medicine, Toranomon Hospital, Minato-ku, Tokyo 105-8470, Japan. hafujimoto-circ@umin.ac.jp
Hajime
H
Fujimoto
Susumu
S
Tao
Jun
J
Masuda
Haruo
H
Mitani
Sachiko
S
Ito
Yo
Y
Fujimoto
Akiko
A
Maehara
Sugao
S
Ishiwata
Tetsu
T
Yamaguchi
Minoru
M
Ohno
D000368:Aged; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D009203:Myocardial Infarction / Q000628:therapy*; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome
D008670:Metals