1. Impact of sirolimus-eluting stents on outcomes of patients treated for acute myocardial infarction by primary angioplasty
- Author
-
Kenneth M. Kent, Edouard Cheneau, Pramod K. Kuchulakanti, Lowell F. Satler, Ron Waksman, Rebecca Torguson, Eugenio Stabile, Augusto D. Pichard, Seung-Woon Rha, Tim Kinnaird, Cheneau, E, Rha, Sw, Kuchulakanti, Pk, Stabile, Eugenio, Kinnaird, T, Torguson, R, Pichard, Ad, Satler, Lf, Kent, Km, and Waksman, R.
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Primary angioplasty ,Myocardial Infarction ,Coronary Angiography ,Blood Vessel Prosthesis Implantation ,Postoperative Complications ,Coated Materials, Biocompatible ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,Myocardial infarction ,Hospital Mortality ,Angioplasty, Balloon, Coronary ,Aged ,Retrospective Studies ,Sirolimus ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,General Medicine ,Middle Aged ,medicine.disease ,Treatment Outcome ,Drug-eluting stent ,Conventional PCI ,District of Columbia ,Cardiology ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business ,TIMI ,Immunosuppressive Agents ,medicine.drug - Abstract
Sirolimus-eluting stents (SESs) are currently being used in patients undergoing percutaneous coronary intervention (PCI). SESs have not been evaluated in the treatment of acute myocardial infarction by primary angioplasty. We report our initial experience with SESs implanted during primary angioplasty. One hundred and three patients were treated within 12 hr after onset of acute myocardial infarction (AMI) with primary angioplasty and SES implantation. Those patients were compared to 504 patients treated with bare metal stents (BMSs). Angiographic success (TIMI flow grade 3 and residual stenosis < 50%) was completed in 98% of patients with SESs and no subacute stent thrombosis was reported. In-hospital outcomes were similar in the SES and BMS groups. At 6 months, major cardiac events were less frequent in the SES group than in the BMS group (9% vs. 24%, respectively; P < 0.001), driven by a lesser need for repeat revascularization with SESs (1% vs. 10.3% with BMSs; P = 0.014). Mortality at 6 months was 7% with SESs and 11% with BMSs (P = 0.14). SESs are safe and effective for the treatment of AMI by primary angioplasty. As compared to BMSs, SESs improve long-term outcome after AMI, mainly by reducing the need for repeat revascularization.
- Published
- 2005