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Previous Volume 355:1105-1113 September 14, 2006 Number 11 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Editorial by Van de Werf, F. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Drug-eluting coronary-artery stents have been shown to decrease restenosis and therefore the likelihood that additional procedures will be required after percutaneous coronary intervention (PCI). We evaluated the use of a drug-eluting stent in patients undergoing PCI for acute myocardial infarction with ST-segment elevation.

Methods We randomly assigned 619 patients presenting with an acute myocardial infarction with ST-segment elevation to receive either a paclitaxel-eluting stent or an uncoated stent. The primary end point was a composite of death from cardiac causes, recurrent myocardial infarction, or target-lesion revascularization at 1 year.

Results Baseline clinical and angiographic characteristics in both groups were well matched. There was a trend toward a lower rate of serious adverse events in the paclitaxel-stent group than in the uncoated-stent group (8.8% vs. 12.8%; adjusted relative risk, 0.63; 95% confidence interval, 0.37 to 1.07; P=0.09). A nonsignificant trend was also detected in favor of the paclitaxel-stent group, as compared with the uncoated-stent group, in the rate of death from cardiac causes or recurrent myocardial infarction (5.5% vs. 7.2%, P=0.40) and in the rate of target-lesion revascularization (5.3% vs. 7.8%, P=0.23). The incidence of stent thrombosis during 1 year of follow-up was the same in both groups (1.0%).

Conclusions Although the use of paclitaxel-eluting stents in acute myocardial infarction with ST-segment elevation reduced the incidence of serious adverse cardiac events at 1 year by 4.0 percentage points, as compared with uncoated stents, the difference was not statistically significant. (Current Controlled Trials number, ISRCTN65027270 [controlled-trials.com] .)

Source Information

From the Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam (G.J.L., M.T.D., L.H., F.K., T.S., L.R.W., M.P.); the Department of Interventional Cardiology, St. Antonius Hospital, Nieuwegein (M.J.S., B.J.R.); and the Department of Cardiology, Academic Medical Center, Amsterdam (J.G.P.T.) — all in the Netherlands.

Address reprint requests to Dr. Laarman at the Department of Interventional Cardiology, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1090 HM Amsterdam, the Netherlands, or at g.j.laarman{at}olvg.nl.

Full Text of this Article

Related Letters:

Drug-Eluting Stents in Primary PCI
Alfonso F., Jneid H., Maree A. O., Palacios I. F., Valgimigli M., Percoco G., Bolognese L., Spaulding C., Henry P., Teiger E., Laarman G. J., Van de Werf F.
Extract | Full Text | PDF  
N Engl J Med 2006; 355:2483-2486, Dec 7, 2006. Correspondence

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