Long-Term Outcome After Drug-Eluting Versus Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction 3-Year Follow-Up of the Randomized DEDICATION (Drug Elution and Distal Protection in Acute Myocardial Infarction) Trial

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:56

Article

Kaltoft, Anne²  Kelbaek, Henning¹  Thuesen, Leif²  Lassen, Jens Flensted²  Botker, Hans E.²  Krusell, Lars R.²  Christiansen, Evald H.²  Ravkilde, Jan²  Terkelsen, Christian J.² 

[1] Univ Copenhagen, Rigshosp, Dept Cardiol, Ctr Heart,Cardiac Catheterizat Lab, DK-2100 Copenhagen, Denmark

[2] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark

关键词: acute MI;    drug-eluting stent;    reinfarction;    stent thrombosis;    primary PCI;   

DOI  :  10.1016/j.jacc.2010.05.009

来源: Elsevier

【 摘 要 】

Objectives The purpose of this study was to compare long-term clinical outcomes after implantation of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI). Background The evidence of long-term efficacy and safety after implantation of DES in patients with complex lesions is scarce. Methods We randomly assigned 626 patients with STEMI referred within 12 h to have a DES or a BMS implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention. Results At 3 years, target lesion revascularization was 6.1% in the DES group compared with 16.3% in the BMS group (p < 0.001), and the rate of major adverse cardiac events was 11.5% versus 18.2%, respectively (p = 0.02). Whereas all-cause mortality did not differ significantly, the rate of cardiac death was higher in the DES group, 6.1% versus 1.9% for the BMS group (p = 0.01). The occurrence of reinfarction, stroke, and stent thrombosis was similar. Conclusions Implantation of DES in patients with STEMI reduces the long-term rate of major adverse cardiac events compared with BMS, but patients with DES had a higher risk of cardiac death not attributed to myocardial infarction or stent thrombosis. (Drug Elution and Distal Protection During Percutaneous Coronary Intervention in ST Elevation Myocardial Infarction [DEDICATION]; NCT00192868) (J Am Coll Cardiol 2010; 56: 641-5) (C) 2010 by the American College of Cardiology Foundation

【 授权许可】

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