Long-term effects of drug-eluting stents versus bare metal stents on patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention： outcomes of 3-year clinical follow-up

作     者：WANG Chong-hui FANG Quan ZHANG Shu-yang SHEN Zhu-jun FAN Zhong-jie J1N Xiao-feng ZENG Yong LIU Zhen-yu XIE Hong-zhi YANG Ming 

作者机构：Department of CardiologyPeking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2012年第125卷第16期

页      面：2803-2806页

核心收录：

学科分类：1007[医学-药学(可授医学、理学学位)] 08[工学] 09[农学] 0901[农学-作物学] 0836[工学-生物工程] 090102[农学-作物遗传育种] 10[医学] 

主　　题：drug-eluting stents bare metal stents myocardial infarction," prognosis 

摘      要：Background The long-term safety and efficacy of drug-eluting stents （DES） versus bare metal stents （BMS） are unclear and controversial issues in patients with acute ST-elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PCI）. The purpose of this study was to compare the long-term outcome of STEMI patients undergoing primary PCI with DES versus BMS implantation. Methods A total of 191 patients with acute STEMI undergoing PCI from Jan. 2005 to Dec. 2007 were enrolled. Patients received DES （n=83） or BMS （n=108） implantation in the infarction related artery according to physician＇s discretion. The primary outcome was the occurrence of major adverse cardiac events （MACE）, which was defined as a composite of death, myocardial infarction （MI）, target vessel revascularization （TVR） and stent thrombosis. The difference of MACE was observed between DES and BMS groups. Results The clinical follow-up duration was 3 years （（41.7±16.1） months）. MACE occurred in 20 patients during three years follow-up. Logistic regression analysis showed that the left ventricular ejection fraction （LVEF） was an independent predictor for MACE in the follow-up period （P=0.0301）. There was no significant difference in all-cause mortality （3.61% vs. 7.41%, P=0.2647）, the incidence of myocardial infarction （0 vs. 0.93%, P=-0.379） and stent thrombosis （1.20% vs. 1.85%, P=0.727） between the DES group and BMS group. The incidence of MACE was significantly lower in the DES group compared to the BMS group （4.82% vs. 14.81%, P=0.0253）. The rate of TVR was also lower in the DES group （0 vs. 5.56%, P=0.029）. In the DES group, there was no significant difference in the incidence of MACE between sirolimus eluting stents （SES, n=73） and paclitaxel-eluting stents （PES, n=10） subgroups （2.74% vs. 20.00%, P 〉0.05）. Conclusions This finding suggested that drug-eluting stents significantly reduced the need for revascularization in patients with acute STEMI, without increasi