title: Clinical outcomes of serolimus-eluting stents versus bare metal stents in ST-segment elevation myocardial infarction patients: a meta-analysis.
abstract: BACKGROUND
  The benefits and safety of sirolimus-eluting stent (SES) have not been systematically quantified in different trials in ST-segment elevation myocardial infarction (STEMI) patients with primary or rescue percutaneous coronary intervention (PCI). A meta-analysis of randomised trials comparing SES and bare-metal stent (BMS) was performed.
  
  
  METHODS
  A systematic literature search was conducted to identify all randomized clinical trials. The primary outcome was the rate of major adverse cardiac events (MACEs). The secondary outcomes included death, recurrent myocardial infarction, recurrent revascularization, and stent thrombosis.
  
  
  RESULTS
  Totally, 1973 STEMI patients were enrolled in seven eligible randomized trials comparing SES with BMS. The pooled rate of major adverse cardiac events was significantly lower in the SES group than in the BMS group (9.7% vs 20.3%, OR 2.45, 95% CI 1.88-3.19, P < 0.00001). No significant difference in all causes of death was found between the SES and BMS groups, as well as in the pooled recurrent myocardial infarction rates. The pooled recurrent revascularization rate was significantly lower in the SES group than in the BMS group (5.1% vs 14.8%, OR 3.30, 95% CI 2.37-4.60, P < 0.00001). No significant difference was found between the pooled rates of stent thrombosis (1.2% in the SES group and 2.0% in the BMS group, OR 1.61, 95% CI 0.79-3.26, P = 0.19).
  
  
  CONCLUSIONS
  SES is associated with a decreased risk of major adverse cardiac events compared with BMS by the greater reduction in repeat revascularization in STEMI patients. Larger trials with longer follow up are warranted to better define the role of SES in STEMI.
authors.affiliation: Department of Cardiology, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China.
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Pan
authors.forename: Wen-zhao
authors.initials: WZ
authors.lastname: Zhong
authors.forename: Mei-xiang
authors.initials: MX
authors.lastname: Xiang
authors.forename: Geng
authors.initials: G
authors.lastname: Xu
authors.forename: Jiang
authors.initials: J
authors.lastname: Shan
authors.forename: Jian-an
authors.initials: JA
authors.lastname: Wang
mesh_terms: D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D009203:Myocardial Infarction / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000008:administration & dosage* / Q000009:adverse effects* / Q000737:chemistry; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus