title: Retrospective comparison of clinical and angiographic outcomes after primary stenting using sirolimus-eluting and bare-metal stents in nonrandomized consecutive 568 patients with first ST-segment elevated myocardial infarctions.
abstract: OBJECTIVE
  The long-term safety and efficacy of primary stenting using drug-eluting stents (DES) in patients with ST-segment elevation myocardial infarction (STEMI) are not fully understood in Japan. Therefore, we retrospectively examined the midterm clinical and angiographic outcomes in STEMI patients after primary stenting using sirolimus-eluting stents (SES) in a clinical setting through a historical comparison with those of bare-metal stents (BMS).
  
  
  RESULTS
  The study design was a retrospective, nonrandomized, and single-center study. The clinical outcomes for 568 consecutive patients who presented within 12 h of their first STEMI and who were treated with BMS (n = 198; 184 STEMIs from June 2003 to August 2004 and 14 STEMIs from September 2004 to May 2007) or SES (n = 370; from August 2004 to May 2007) at our medical center in Japan were retrospectively investigated in February 2010. The incidence of post-discharge events (comprising cardiac death and nonfatal recurrent MI) after SES placement (3.9%) was not significantly different from that after BMS placement (6.7%). SES was not related to the risk of post-discharge events (mean follow-up for SES, 1327 ± 415 days; BMS, 1818 ± 681 days) (hazard ratio of 0.369 at 95% CI, 0.119-1.147, p = 0.085). The incidence of definite stent thromboses after SES placement (0.54%) was not significantly higher than that after BMS placement (0%). The incidence of binary in-stent restenosis (% diameter stenosis of more than 50% at secondary angiography) after SES placement (8.3%) was significantly lower than that after BMS placement (25.7%; p < 0.001).
  
  
  CONCLUSIONS
  From the present historical comparison of SES and BMS, we conclude that primary stenting using SES in a clinical setting has favorable clinical and angiographic outcomes in Japanese STEMI patients.
authors.affiliation: Department of Cardiology, Saitama Prefecture Cardiovascular Respiratory Center, Saitama, Japan. ishikawa.tetsuya@pref.saitama.lg.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Mutoh
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakano
authors.forename: Akira
authors.initials: A
authors.lastname: Endo
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Kubota
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nakata
authors.forename: Akimichi
authors.initials: A
authors.lastname: Murakami
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Hisayuki
authors.initials: H
authors.lastname: Okada
authors.forename: Kamon
authors.initials: K
authors.lastname: Imai
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus