Safety and efficacy of drug-eluting stents in patients with acute myocardial infarction-From first generation to second generation of drug-eluting stents

摘要

The efficacy of bare metal stent (BMS) in acute myocardial infarction (AMI) has already been confirmed and the CADILLAC trial showed that major adverse cardiac events (MACE) were significantly lower in the BMS group than in the group of old balloon angioplasty alone [1]. Regarding the first-generation drug-eluting stent (DES), in the TYPHOON study [2] using sirolimus-eluting stents (SES) and the HORIZON-AMI study using paclitaxel-eluting stents (PES) [3], no difference in safety including stent thrombosis and all-cause mortality between the groups was found and target vessel revascularization (TVR) dramatically decreased in the DES group. Meta-analysis was conducted using 13 randomized trials and confirmed no significant difference in one-year outcome, death, and incidence of myocardial infarction (MI) between the BMS and the first-generation DES groups or no significant difference in stent thrombosis between the DES and BMS groups. On the other hand, DES decreased risks for TVR in chronic phase by 56% in comparison with BMS [4].