title: The Japanese experience with sirolimus-eluting stent implantation in the infarct-related artery: five years of observation from the J-PMS study.
abstract: BACKGROUND
  Long-term outcome and safety concerns regarding drug-eluting stents (DES) for acute myocardial infarction (AMI) treatment is still debated.
  
  
  RESULTS
  We analyzed data from 1937 patients with complete 5-year follow-up (94.5%) from a multicenter registry of sirolimus-eluting stents (J-PMS). The patients were divided into 2 groups: AMI (n=133) and non-AMI (n=1804) by clinical presentation of index procedure, and compared the outcomes. At 5-year follow-up, there were no significant differences in major adverse cardiac events (MACE), death, MI, or stent thrombosis between the groups. However, target vessel related events (TVF; revascularization, cardiac death, MI, thrombosis) were higher in the non-AMI group (p=0.03). In the early phase (0-6 months), MACE and death/MI were higher in the AMI group (6.0% vs. 3.0%; p=0.02 and 6.8% vs. 2.1%; p<0.001). However, in the late phase (6-60 months), there was a difference in TVF between the 2 groups, with a steady increase in the non-AMI group (p=0.03). Over 60% of patients with AMIs were started on dual antiplatelet therapy after stent implantation or on the same day. However, dual anti-platelet therapy duration was similar (867 ± 18 days in the AMI and 727 ± 57 days in the non-AMI group, p=0.5). Frequency of bleeding was similar.
  
  
  CONCLUSIONS
  Five-year observation of AMI treatment using drug-eluting stent compared with non-AMI has no clinical disadvantage.
authors.affiliation: National Cerebral and Cardiovascular Center, Suita, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Adachi
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kotani
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
authors.forename: Eisho
authors.initials: E
authors.lastname: Kyo
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D020123:Sirolimus