Long-Term Clinical and Angiographic Follow-up of Drug-Eluting Stents in Patients With ST-Elevation Acute Myocardial Infarction

Introduction and objectives Drug-eluting stents (DES) have proven to be effective in reducing the rate of restenosis and have, therefore, been incorporated into the treatment of patients with ST-elevation acute myocardial infarction (STEMI). The aim of this study was to investigate long-term clinical and angiographic outcomes following the use of DESs in patients with STEMI. Methods A prospective study involving clinical and angiographic follow-up was performed in 81 patients with STEMI who underwent percutaneous coronary intervention including DES implantation. This group was compared with 82 patients with similar characteristics who were treated with bare-metal stents (BMS) in an earlier period. Results At one year, there was no significant difference between the groups in the mortality (2.5% in the DES group vs 7.3% in the BMS group; P =.15) or reinfarction rate (4.8% in the DES group vs 4.8% in the BMS group; P =.98). The target lesion revascularization rate was significantly lower in the DES group (8.6% vs 23.2% in the BMS group; P =.001), as was the restenosis rate (13.8% vs 30.9% in the BMS group; P =.02). Acute or subacute stent thrombosis was diagnosed in 5 patients (3 with a DES and 2 with a BMS; P =.64), and one late stent thrombosis was detected after a year, in a sirolimuseluting stent. Conclusions Implantation of a DES in patients with STEMI did not result in a reduction in either the mortality or reinfarction rate at 1 year compared with BMS implantation. However, there were reductions in the rates of restenosis and target lesion revascularization. The incidence of thrombosis was similar with the 2 types of stent.