Author + information
- Received October 31, 2006
- Revision received January 11, 2007
- Accepted January 16, 2007
- Published online May 15, 2007.
- Maurizio Menichelli, MD⁎,⁎ (, )
- Antonio Parma, MD⁎,
- Edoardo Pucci, MD⁎,
- Rosario Fiorilli, MD⁎,
- Francesco De Felice, MD⁎,
- Marco Nazzaro, MD⁎,
- Alessia Giulivi, MD⁎,
- Domenico Alborino, MD⁎,
- Arianna Azzellino, PhD† and
- Roberto Violini, MD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Maurizio Menichelli, Department of Cardiology, San Camillo Hospital, Circ. Gianicolense 187, 00100 Rome, Italy.
Objectives To confirm whether sirolimus-eluting stents (SES) safely reduce the incidence of restenosis in patients with ST-segment elevation acute myocardial infarction compared with bare-metal stents (BMS).
Background In the setting of primary angioplasty, stent restenosis occurs in up to 27% of patients. The introduction of drug-eluting stents has drastically reduced the incidence of restenosis in clinically stable patients.
Methods We conducted a randomized trial of 320 patients with acute ST-segment elevation myocardial infarction assigned to receive SES or BMS. The primary end point was binary restenosis at 1-year angiographic follow-up.
Results At 1 year, the incidence of binary restenosis was lower in the SES group than in the BMS group (9.3% vs. 21.3%, respectively; p = 0.032), as were the rates of target lesion revascularization (4.3% vs. 11.2%; p = 0.02), target vessel revascularization (5% vs. 13.1; p = 0.015), major adverse cardiac events (6.8% vs. 16.8%; p = 0.005), and target vessel failure (8.7% vs. 18.7%; p = 0.007). The incidence of angiographically documented stent thrombosis was 1.2% (n = 2) in the SES group and 0.6% (n = 1) in the BMS group.
Conclusions In patients with acute myocardial infarction, SES are superior to BMS, reducing the incidence of binary restenosis by 56%, target lesion revascularization by 61%, target vessel revascularization by 62%, adverse cardiac events by 59%, and target vessel failure by 53% at 1 year. (Sirolimus Eluting Stenting in Acute Myocardial Infarction; http://www.clinicaltrials.gov/ct/show/NCT00288210; NCT00288210)
- Received October 31, 2006.
- Revision received January 11, 2007.
- Accepted January 16, 2007.
- American College of Cardiology Foundation