Major adverse cardiac events at follow-up after bare-metal stenting versus drug-eluting stenting in ST-elevated myocardial infarction

Am J Cardiol. 2009 Jun 15;103(12):1672-4. doi: 10.1016/j.amjcard.2009.02.016. Epub 2009 Apr 16.

Abstract

After thrombolytic therapy with tenecteplase for ST-segment elevation acute myocardial infarction, 376 patients were transferred from their hospital to Westchester Medical Center for percutaneous coronary intervention with stenting. Of 376 patients, 102 (27%) received bare-metal stents and 274 (73%) received drug-eluting stents with sirolimus-eluting or paclitaxel-eluting stents. At 43 months of follow-up, major adverse cardiac events occurred in 25 (25%) of 102 patients treated with bare-metal stents versus 40 (15%) of 274 patients treated with drug-eluting stents (p = 0.024). Cox regression analysis showed that significant independent prognostic factors for major adverse cardiac events were previous coronary artery bypass surgery (hazard ratio 2.2, p = 0.019), width of stent (hazard ratio 0.44, p = 0.006), and bare-metal stent (hazard ratio 1.8, p = 0.019). In conclusion, patients with bare-metal stents had a 1.8 times greater risk of developing major adverse cardiac events than did those using drug-eluting stents after controlling the confounding effects of previous coronary artery bypass surgery and stent width.

Publication types

  • Comparative Study

MeSH terms

  • Angioplasty, Balloon, Coronary / methods*
  • Drug-Eluting Stents*
  • Electrocardiography*
  • Female
  • Follow-Up Studies
  • Graft Occlusion, Vascular / epidemiology*
  • Graft Occlusion, Vascular / etiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality
  • Myocardial Infarction / surgery*
  • New York / epidemiology
  • Prognosis
  • Risk Factors
  • Survival Rate / trends
  • Time Factors