Background Clinical studies with drug eluting stents (DES) in coronary disease have shown promising results. However, it is uncertain that which of commercially available 2 DES, paclitaxel-eluting stent (PES) and sirolimus-eluting stents (SES), is more effective for the treatment of ST-elevation myocardial infarction (STEMI). This study was designed to determine the safety and efficacy of two kinds of DES for these lesions.
Methods From Jan 2004 to Feb 2005, 226 consecutive patients underwent primary angioplasty for the treatment of STEMI. Among them, 15 patients were excluded (8 with bare-metal stents, 5 with balloon angioplasty only, and 2 procedural death before stenting) and 211 patients were randomly assigned to PES (Group I, n=105) or SES (Group II, n=106). Six month angiographic restenosis and incidence of major adverse cardiac events were assessed.
Results The baseline clinical and angiographic characteristics were similar between 2 groups. During the 10 months of follow-up, 14 patients were died (9 in group I and 5 in group II). There were one acute stent thrombosis in group I and one subacute stent thrombosis in group II. Six-month angiographic follow-up was performed in 76% of eligible patients. PES patients showed higher angiographic in-segment restenosis (16% vs. 4%, P=0.02) and higher late loss (0.58mm vs. 0.14mm, P<0.01) than SES. The target lesion revascularization rate was 4% (6 patients in group I, and 2 in group II, p=0.13).
Conclusions DES implantation demonstrated safe and favorable clinical outcomes in unselected STEMI patients treated with primary angioplasty. SES was more effective in preventing angiographic restenosis compared with PES.