title: Drug-eluting versus bare-metal stents in ST-segment elevation myocardial infarction: a mortality analysis from the EUROTRANSFER Registry.
abstract: OBJECTIVE
  To assess the patterns of drug-eluting stent (DES) and bare-metal stent (BMS) implantation and associated real-life outcomes in patients with ST-segment elevation myocardial infarction (STEMI) transferred for primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Data were gathered for 1,650 consecutive STEMI patients transferred for primary PCI from hospital networks in seven countries of Europe from November 2005 to January 2007. We identified 1,428 patients with ≥1 stent implanted (86.5%). DES were implanted in 382 patients (26.8%) and BMS in 1,046 patients (73.2%) of 1,428 who received stent.
  
  
  RESULTS
  High variability in DES use among countries participating in the registry (range from 6.8 to 72.1%) was observed. The use of DES in STEMI declined during the fourth quarter of 2006 through the first quarter of 2007. In the assessed population, age, previous PCI, systolic and diastolic pressures on admission, clopidogrel before admission, left anterior descending artery as the infarct-related artery, and thrombus aspiration device use were identified as the independent predictors of DES implantation. Use of DES was associated with significantly lower rates of ischemic events during follow-up (1-year mortality: BMS vs. DES: 6.7% vs. 3.1%; p = 0.014), but observed difference was no longer significant after adjustment for propensity score (adjusted OR (95% CI): 0.55 (0.28-1.06); p = 0.07).
  
  
  CONCLUSIONS
  In this large, prospective European registry, the presence of large geographical and temporal variation of DES utilization in STEMI in Europe was confirmed. DES in STEMI appear to be as safe as BMS, with similar mortality after adjustment for potential confounders and trend toward lower 1-year mortality in patients treated with DES.
authors.affiliation: Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Siudak
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Ralf
authors.initials: R
authors.lastname: Birkemeyer
authors.forename: Waldemar
authors.initials: W
authors.lastname: Mielecki
authors.forename: Paweł
authors.initials: P
authors.lastname: Ranosz
authors.forename: Jacek S
authors.initials: JS
authors.lastname: Dubiel
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D015995:Prevalence; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D008670:Metals