title: Long-term outcome after drug-eluting versus bare-metal stent implantation in patients with ST-segment elevation myocardial infarction: 3-year follow-up of the randomized DEDICATION (Drug Elution and Distal Protection in Acute Myocardial Infarction) Trial.
abstract: OBJECTIVE
  The purpose of this study was to compare long-term clinical outcomes after implantation of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  BACKGROUND
  The evidence of long-term efficacy and safety after implantation of DES in patients with complex lesions is scarce.
  
  
  METHODS
  We randomly assigned 626 patients with STEMI referred within 12 h to have a DES or a BMS implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention.
  
  
  RESULTS
  At 3 years, target lesion revascularization was 6.1% in the DES group compared with 16.3% in the BMS group (p<0.001), and the rate of major adverse cardiac events was 11.5% versus 18.2%, respectively (p=0.02). Whereas all-cause mortality did not differ significantly, the rate of cardiac death was higher in the DES group, 6.1% versus 1.9% for the BMS group (p=0.01). The occurrence of reinfarction, stroke, and stent thrombosis was similar.
  
  
  CONCLUSIONS
  Implantation of DES in patients with STEMI reduces the long-term rate of major adverse cardiac events compared with BMS, but patients with DES had a higher risk of cardiac death not attributed to myocardial infarction or stent thrombosis. (Drug Elution and Distal Protection During Percutaneous Coronary Intervention in ST Elevation Myocardial Infarction [DEDICATION]; NCT00192868)
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Kaltoft
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbaek
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Jens Flensted
authors.initials: JF
authors.lastname: Lassen
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen
authors.forename: Lene
authors.initials: L
authors.lastname: Kløvgaard
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.forename: Hans E
authors.initials: HE
authors.lastname: Bøtker
authors.forename: Kari
authors.initials: K
authors.lastname: Saunamäki
authors.forename: Lars R
authors.initials: LR
authors.lastname: Krusell
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.forename: Hans-Henrik
authors.initials: HH
authors.lastname: Tilsted
authors.forename: Evald H
authors.initials: EH
authors.lastname: Christiansen
authors.forename: Jan
authors.initials: J
authors.lastname: Ravkilde
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Kofoed
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Terkelsen
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
mesh_terms: D000800:Angioplasty, Balloon; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology