Three-year prognosis of Japanese patients with ST-elevation myocardial infarction treated with sirolimus-eluting stents.
OBJECTIVE
The long-term prognosis of Japanese ST-elevation myocardial infarction (STEMI) patients treated with sirolimus-eluting stents (SESs) still remains unclear. We aimed to determine the 3-year outcomes of this population.


RESULTS
Major adverse cardiac events (MACE) defined as all-cause death, reinfarction, and target vessel revascularization during 3 years, angiographic data, and events of stent thrombosis were compared between 95 consecutive STEMI patients treated with SESs and 94 treated with bare-metal stents (BMSs). Significant advantages were discerned in all follow-up angiographic data from the SES group. The rate of target vessel revascularization was significantly less in the SES group than in the BMS group (P = 0.006). There was no significant difference in the rates of mortality (P = 0.258) or reinfarction (P = 0.496). The Kaplan-Meier analysis showed that at a 3-year follow-up, MACE-free survival was significantly higher in the SES group than in the BMS group (log-rank P<0.001). Academic Research Consortium 'definite' or 'probable' stent thrombosis was observed in two patients ('early' and 'very late') in the SES group and no patient in the BMS group. We observed no significant difference in the event rates of stent thrombosis (2.1% SES group vs. 0% BMS group, P = 0.497).


CONCLUSIONS
In Japanese STEMI patients, a 3-year follow-up showed that the routine use of SESs reduces the incidence of MACE without increasing the risk of stent thrombosis.
Yoshikawa
Daiji
D
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Isobe
Satoshi
S
Umeda
Hisashi
H
Kawai
Tomoko
T
Shimizu
Takeshi
T
Yamashita
Kentaro
K
Ishii
Hideki
H
Murohara
Toyoaki
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D044466:Asian People; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D008670:Metals; D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus