|2004/2005/2007 Recommendations||2009 Joint STEMI/PCI Focused Update Recommendations||Comments|
|1. It is reasonable to use a DES as an alternative to a BMS for primary PCI in STEMI (11,105). (Level of Evidence: B)⁎||New recommendation|
|2007 PCI Guideline Update, Table 16|
|1. A DES may be considered for clinical and anatomic settings in which the effectiveness/safety profile appears favorable but has not been fully confirmed by clinical trials. (Level of Evidence: C)||1. A DES may be considered for clinical and anatomic settings†in which the efficacy/safety profile appears favorable (106–109). (Level of Evidence: B)||Modified recommendation (level of evidence changed from C to B).|
↵⁎ Consideration for the use of stents (DES or BMS) in STEMI should include the ability of the patient to comply with prolonged dual-antiplatelet therapy, the bleeding risk in patients undergoing chronic oral anticoagulation, and the possibility that the patient may need surgery during the ensuing year (28).
↵† For example, small vessels, long lesions, or diabetes mellitus. This recommendation applies to primary and nonprimary PCI patients with STEMI.