Drug-Eluting Stents in Patients with Acute MI: Reassuring Results

One-year results of a large randomized study suggest that DES are as safe as BMS and yield lower TLR rates.

Concerns about stent thrombosis in high-risk patients and in those with complex lesions have prompted many interventionalists to avoid using drug-eluting stents (DES) when performing primary percutaneous coronary intervention for acute MI. In this randomized trial, investigators assigned 3006 patients with ST–segment-elevation MI to receive (in a 3:1 ratio) paclitaxel-eluting stents (PES) or bare-metal stents (BMS) during PCI. Primary endpoints at 12 months included target-lesion revascularization (TLR) and a safety composite of death, reinfarction, stroke, and stent thrombosis.

Ischemia-driven TLR occurred in a significantly smaller proportion of PES recipients than BMS recipients (4.5% vs. 7.5%; hazard ratio, 0.59). A 35% reduction in targ…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI