title: Long-term clinical outcome in STEMI patients treated with primary PCI and drug-eluting or bare-metal stents: insights from a high-volume single-center registry.
abstract: OBJECTIVE
  Use of drug-eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI) during routine primary percutaneous coronary intervention (pPCI) is controversial.
  
  
  METHODS
  From January 2004 to July 2008, a total of 2,155 STEMI patients were treated with pPCI [DES or bare-metal stent (BMS)] at a single high-volume invasive center. We present 4-year outcomes in this observational registry study.
  
  
  RESULTS
  A total of 1,725 were treated with DES and 430 with BMS. Patients treated with DES were younger and had more complex angiographic characteristics compared to BMS patients. Patients treated with DES had lower adjusted risk of target lesion revascularization (TLR) [hazard ratio (HR) = 0.68; 95% confidence interval (CI): 0.40-0.98; p = 0.04], but had a trend toward increased risk of definite stent thrombosis (HR = 1.96; 95% CI: 0.83-4.61; p = 0.12). No difference was found when evaluating all-cause mortality and non-fatal myocardial infarction.
  
  
  CONCLUSIONS
  In this study, we set out to evaluate the independent impact of DES or BMS treatment on long-term clinical outcomes in STEMI patients treated with pPCI in a real-life setting. DES use was associated with a reduced risk of TLR, but a trend toward increased risk of stent thrombosis was found. However, this safety issue did not translate into an increased risk of death or overall non-fatal myocardial infarction for DES patients.
authors.affiliation: Department of Cardiology P, Gentofte University Hospital, Niels Andersens Vej 65, DK-2900, Copenhagen Denmark. peidersen@hotmail.com
authors.forename: Sune
authors.initials: S
authors.lastname: Pedersen
authors.forename: Soren
authors.initials: S
authors.lastname: Galatius
authors.forename: Rasmus
authors.initials: R
authors.lastname: Mogelvang
authors.forename: Steen Z
authors.initials: SZ
authors.lastname: Abildstrom
authors.forename: Rikke
authors.initials: R
authors.lastname: Sorensen
authors.forename: Anders
authors.initials: A
authors.lastname: Galloe
authors.forename: Ulrik
authors.initials: U
authors.lastname: Abildgaard
authors.forename: Peter
authors.initials: P
authors.lastname: Hansen
authors.forename: Ulla
authors.initials: U
authors.lastname: Davidsen
authors.forename: Allan
authors.initials: A
authors.lastname: Iversen
authors.forename: Jan
authors.initials: J
authors.lastname: Bech
authors.forename: Jan K
authors.initials: JK
authors.lastname: Madsen
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology; D003718:Denmark; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D008670:Metals