title: Long-term outcomes of drug-eluting versus bare-metal stent for ST-elevation myocardial infarction.
abstract: BACKGROUND
  Long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remain uncertain.
  
  
  OBJECTIVE
  To investigate long-term outcomes of drug-eluting stents (DES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  We performed search of MEDLINE, EMBASE, the Cochrane library, and ISI Web of Science (until February 2013) for randomized trials comparing more than 12-month efficacy or safety of DES with BMS in patients with STEMI. Pooled estimate was presented with risk ratio (RR) and its 95% confidence interval (CI) using random-effects model.
  
  
  RESULTS
  Ten trials with 7,592 participants with STEMI were included. The overall results showed that there was no significant difference in the incidence of all-cause death and definite/probable stent thrombosis between DES and BMS at long-term follow-up. Patients receiving DES implantation appeared to have a lower 1-year incidence of recurrent myocardial infarction than those receiving BMS (RR = 0.75, 95% CI 0.56 to 1.00, p= 0.05). Moreover, the risk of target vessel revascularization (TVR) after receiving DES was consistently lowered during long-term observation (all p < 0.01). In subgroup analysis, the use of everolimus-eluting stents (EES) was associated with reduced risk of stent thrombosis in STEMI patients (RR = 0.37, p=0.02).
  
  
  CONCLUSIONS
  DES did not increase the risk of stent thrombosis in patients with STEMI compared with BMS. Moreover, the use of DES did lower long-term risk of repeat revascularization and might decrease the occurrence of reinfarction.
authors.forename: Liping
authors.initials: L
authors.lastname: Wang
authors.forename: Hongyun
authors.initials: H
authors.lastname: Wang
authors.forename: Pingshuan
authors.initials: P
authors.lastname: Dong
authors.forename: Zhuanzhen
authors.initials: Z
authors.lastname: Li
authors.forename: Yanyu
authors.initials: Y
authors.lastname: Wang
authors.forename: Nana
authors.initials: N
authors.lastname: Duan
authors.forename: Yuwei
authors.initials: Y
authors.lastname: Zhao
authors.forename: Shaoxin
authors.initials: S
authors.lastname: Wang
mesh_terms: D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals