title: Comparing the use of cobalt chromium stents to stainless steel stents in primary percutaneous coronary intervention for acute myocardial infarction: a prospective registry.
abstract: OBJECTIVE
  To determine clinical outcome and rates of target vessel revascularization (TVR) in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI who were treated with cobalt-chromium stents compared to stainless steel bare metal stents (BMS).
  
  
  BACKGROUND
  The newer generation cobalt chromium stents were reported to achieve lower rates of TVR compared with conventional BMS.
  
  
  METHODS
  Consecutive STEMI cases admitted within 12 h of symptom onset and undergoing primary angioplasty and bare metal stent implantation 1 January 2002 and 31 December 2008 were identified. Primary outcomes were rates of clinically-driven TVR at six months as well as occurrence of major adverse cardiovascular events (MACE) either of all-cause death, repeat myocardial infarction or TVR at six months.
  
  
  RESULTS
  1030 cases with 1175 lesions (84% males) and median age of 58 years underwent primary PCI for STEMI in our registry. Overall procedural success rate was 98%. Stainless steel stents were inserted in 65% of the culprit lesions (stainless steel, n = 766 versus cobalt chromium, n = 264). Primary outcomes of TVR (3.5% in the stainless steel group and 3.4% in the cobalt chromium group, P = 0.93) and MACE (8.4% in the stainless steel group and 5.3% in the cobalt chromium group, P = 0.11) after six months were no different between the two groups. However, there were more deaths at 30 days in the stainless steel group compared to the cobalt chromium group (3.5% versus 0.4%, HR 4.04 (1.03-3.88), P = 0.04).
  
  
  CONCLUSIONS
  Both cobalt-chromium and stainless steel coronary stents were associated with similar and low risk of clinically-driven TVR.
authors.affiliation: Department of Cardiology, National Heart Centre Singapore, Singapore. angela.koh.s.m@nhcs.com.sg
authors.forename: Angela S
authors.initials: AS
authors.lastname: Koh
authors.forename: L M
authors.initials: LM
authors.lastname: Choi
authors.forename: L L
authors.initials: LL
authors.lastname: Sim
authors.forename: Jack W
authors.initials: JW
authors.lastname: Tan
authors.forename: L W
authors.initials: LW
authors.lastname: Khin
authors.forename: Terrance S J
authors.initials: TS
authors.lastname: Chua
authors.forename: T H
authors.initials: TH
authors.lastname: Koh
authors.forename: Stanley
authors.initials: S
authors.lastname: Chia
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002857:Chromium; D003035:Cobalt; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012846:Singapore; D013193:Stainless Steel; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002857:Chromium; D013193:Stainless Steel; D003035:Cobalt