Lack of Clinical Benefit of Improved Angiographic Results With Sirolimus-Eluting Stents Compared With Paclitaxel and Zotarolimus-Eluting Stents in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Abstract

Background: There is limited information regarding the angiographic and clinical outcomes among the different drug-eluting stents (DESs) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods and Results: A total 355 consecutive AMI patients who underwent PCI with a sirolimus- (SES, n=116) or paclitaxel- (PES, n=153) or zotarolimus-eluting stent (ZES, n=86) were enrolled. The 6-month angiographic and 1-year clinical outcomes were compared among the 3 groups. At 6 months, there was a trend toward a higher incidence of binary restenosis in the PES group (SES: 8.6%. PES: 19.8%. ZES: 8.3%, P=0.052). Percentage of restenosis was higher in the PES group Compared with SES, but was similar to ZES (SES: 18.75 +/- 18.16%, PES: 29.32 +/- 24.16%, ZES: 23.91 +/- 17.03%, P=0.006). Late loss was lower in the SES group compared with PES and ZES (SES: 0.44 +/- 0.52, PES: 0.83 +/- 0.87, ZES: 0.75 +/- 0.63, P<0.001). However, clinical outcomes, including mortality, MI, repeat PCI and major adverse cardiac events, were not different among the 3 groups. Conclusions: The angiographic benefit of SES did not translate into a clinical benefit for up to I year in AMI patients. (Circ J 2009; 73: 2229-2235)