title: Drug-eluting stents in acute myocardial infarction: updated meta-analysis of randomized trials.
abstract: BACKGROUND
  Use of drug-eluting stents in patients with acute myocardial infarction (AMI) remains an "off label" indication due to concerns regarding their performance in this patient subset.
  
  
  METHODS
  We searched Medline, the Cochrane Central Register of Controlled Trials, and Internet-based sources of information on clinical trials in cardiology for randomized trials comparing drug-eluting stents with bare-metal stents in patients with AMI. Hazard ratios for the composite of death or recurrent myocardial infarction, (primary safety endpoint), reintervention (primary efficacy endpoint), death, recurrent myocardial infarction, and stent thrombosis were calculated performing a meta-analysis of 14 randomized trials with 7,781 patients.
  
  
  RESULTS
  There was no difference in the hazard of death or recurrent myocardial infarction (hazard ratio, 0.91; [95% CI 0.75-1.09]) between patients treated with drug-eluting stents versus patients treated with bare-metal stents. Treatment with drug-eluting stents resulted in a significant reduction in the hazard of reintervention (0.41 [95% CI 0.32-0.52]). The hazards of death (0.90 [95% CI 0.71-1.15]), myocardial infarction (0.81 [95% CI 0.63-1.04]), and stent thrombosis (0.84 [95% CI 0.61-1.17]) were not significantly different between patients treated with drug-eluting stents versus patients treated with bare-metal stents.
  
  
  CONCLUSIONS
  Use of drug-eluting stents in patients with AMI is safe and markedly reduces the need for reintervention as compared to bare-metal stents.
authors.affiliation: Deutsches Herzzentrum, Technische Universität, Lazarettstr. 36, 80636, Munich, Germany.
authors.forename: Alban
authors.initials: A
authors.lastname: Dibra
authors.forename: Klaus
authors.initials: K
authors.lastname: Tiroch
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schulz
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbaek
authors.forename: Christian
authors.initials: C
authors.lastname: Spaulding
authors.forename: Gerrit J
authors.initials: GJ
authors.lastname: Laarman
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Emilio
authors.initials: E
authors.lastname: Di Lorenzo
authors.forename: Christoph
authors.initials: C
authors.lastname: Kaiser
authors.forename: Ilkka
authors.initials: I
authors.lastname: Tierala
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Maarten A
authors.initials: MA
authors.lastname: Vink
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Roberto
authors.initials: R
authors.lastname: Violini
authors.forename: Albert
authors.initials: A
authors.lastname: Schömig
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D054855:Drug-Eluting Stents; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome