title: Periprocedural (30-day) risk of myocardial infarction after drug-eluting coronary stent implantation: a meta-analysis comparing cobalt-chromium and stainless steel drug-eluting coronary stents.
abstract: OBJECTIVE
  Because of the reduction in the rate events related with in-stent restenosis, most events after drug-eluting stent implantation occur shortly after coronary stenting. Cobalt-chromium alloys allow to reduce strut thickness and improve flexibility and deliverability of coronary stent platforms, and thus could be associated with lower short-term events after stenting. The aim of this study was to test the hypothesis that drug-eluting coronary stents with a cobalt-chromium platform reduce the incidence of periprocedural (30-day) myocardial infarction in comparison with stainless steel drug-eluting coronary stents.
  
  
  RESULTS
  A meta-analysis from nine randomised trials comparing cobalt-chromium and stainless steel drug-eluting coronary stents that overall included 11,313 patients was performed. The incidence of myocardial infarction, stent thrombosis, and cardiac death at 30 days was compared between both types of stents. At 30 days, the incidence of acute myocardial infarction was significantly lower in patients allocated to cobalt-chromium drug-eluting stents (2.3% vs. 3.9%, respectively; p=0.006; odds ratio 0.72, 95% confidence interval 0.58-0.91), due to a significant reduction in the rate of non-Q-wave myocardial infarction (odds ratio 0.67, 95% confidence interval 0.51-0.88). The incidence of stent thrombosis was similar between both groups of patients, (0.5% vs. 0.5%, p=0.76; odds ratio 1.09, 95% confidence interval 0.63-1.89).
  
  
  CONCLUSIONS
  Drug-eluting coronary stents that use cobalt-chromium stent platforms have a better safety profile at 30 days in comparison with stainless steel drug-eluting stents, due to a significant reduction in the rate of myocardial infarction.
authors.affiliation: University Hospital La Paz, Madrid, Spain. raulmorenog@terra.es
authors.forename: Raul
authors.initials: R
authors.lastname: Moreno
authors.forename: Santiago
authors.initials: S
authors.lastname: Jimenez-Valero
authors.forename: Angel
authors.initials: A
authors.lastname: Sanchez-Recalde
authors.forename: Guillermo
authors.initials: G
authors.lastname: Galeote
authors.forename: Luis
authors.initials: L
authors.lastname: Calvo
authors.forename: Roberto
authors.initials: R
authors.lastname: Martin-Reyes
authors.forename: Manuel
authors.initials: M
authors.lastname: Sabate
authors.forename: Ignacio
authors.initials: I
authors.lastname: Plaza
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
authors.forename: Jose-Luis
authors.initials: JL
authors.lastname: Lopez-Sendon
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D002858:Chromium Alloys; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data*; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors; D013193:Stainless Steel
chemical_list: D002858:Chromium Alloys; D013193:Stainless Steel