title: Long-term safety and efficacy of sirolimus- and Paclitaxel-eluting stents in patients with acute myocardial infarction: four-year observational study.
abstract: OBJECTIVE
  The comparison of long-term clinical effects between Sirolimus-eluting stent (SES) and Paclitaxel-eluting stents (PES) for treatment of acute myocardial infarction (AMI) remains unclear. Seeking to clarify this issue, we performed a retrospective analysis to evaluate four-year clinical outcomes of SES compared to PES treated AMI patients.
  
  
  METHODS
  From January 2004 to August 2006, all patients with acute ST-segment elevation myocardial infarction and acute non-ST segment elevation myocardial infarction who underwent percutaneous coronary intervention (PCI) by implantation of either SES or PES were enrolled. The occurrences of cardiac and non-cardiac deaths, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite end points of these major adverse cardiac events (MACE) were also analyzed.
  
  
  RESULTS
  During the study period, a total of 668 AMI patients had visited, of which 522 patients (299 with SES and 223 with PES) were enrolled. During the four-year clinical follow-up, both groups showed similar occurrences of non-cardiac death (14.6±2.2% vs. 18.3±3.0%, p=0.26); cardiac death (6.8±1.52% vs. 11.2±2.6%, p=0.39); re-infarction (3.3±1.1% vs. 6.4±1.8%, p=0.31); and stent thrombosis (3.2±1.1% vs. 5.4±1.7%, p=0.53). However, occurrences of TVR {4.0±1.2% vs. 10.0±3.0%, hazard ratio (HR)=0.498, 95% confidence interval (CI)=0.257-0.967, p=0.039} and MACE (19.4±2.5% vs. 29.4±3.5%, HR=0.645, 95% CI=0.443-0.940, p=0.021) were significantly lower in the SES population.
  
  
  CONCLUSIONS
  In AMI patients treated with either SES or PES implantation, the former had a significantly lower risk of TVR and MACE during four-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.
authors.affiliation: Department of Cardiology, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Gye-Sik
authors.initials: GS
authors.lastname: Min
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Ung-Lim
authors.initials: UL
authors.lastname: Choi
authors.forename: Young-Dal
authors.initials: YD
authors.lastname: Lee
authors.forename: Seok-Woo
authors.initials: SW
authors.lastname: Seong
authors.forename: Seon-Ah
authors.initials: SA
authors.lastname: Jin
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Jun-Hyeong
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae-Hyeong
authors.initials: JH
authors.lastname: Park
authors.forename: Si Wan
authors.initials: SW
authors.lastname: Choi
authors.forename: Jin-Ok
authors.initials: JO
authors.lastname: Jeong
authors.forename: In-Whan
authors.initials: IW
authors.lastname: Seong