• Tina L Pinto Slottow, Daniel H Steinberg, Probal Roy, Aamir Javaid, Ashesh N Buch, Teruo Okabe, Zhenyi Xue, Kimberly Smith, Rebecca Torguson, Augusto D Pichard, Lowell F Satler, William O Suddath, Kenneth M Kent, and Ron Waksman.
• Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
• Cardiovasc Revasc Med. 2008 Jan 1; 9 (1): 24-8.

BackgroundRecent randomized trials have demonstrated conflicting results regarding the use of drug-eluting stents (DESs) as compared to bare metal stents (BMSs) in primary percutaneous coronary intervention (PCI). We compared outcomes among patients presenting with acute ST-elevation myocardial infarction (STEMI) who received DES with those who received BMS.MethodsIn-hospital, 30-day, 6-month, and 1-year outcomes of a cohort of 122 patients who underwent primary or facilitated PCI and received a BMS were compared to 122 propensity-matched patients who received a DES. Seventy-two patients received sirolimus-eluting stents, and 50 received paclitaxel-eluting stents.ResultsBaseline demographics were similar among groups. One-, 6-, and 12-month outcomes, including reinfarction, death, stent thrombosis, and target vessel revascularization (TVR), were similar among groups. At 1 year, all-cause mortality was 13.3% in the BMS group and 9.2% in the DES group [P=not significant (ns)], recurrent MI was 5.3% in the BMS group vs. 4.4% in the DES group (P=ns), and TVR was 7% in the BMS group vs. 8.7% in the DES group (P=ns).ConclusionsOur data do not support the general use of DES in the setting of STEMI given similar cardiovascular outcomes among patients receiving BMS or DES, the need for long-term dual antiplatelet therapy with DES, and the possible repercussions of very late stent thrombosis.

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