Three-year prognosis of Japanese patients with ST-elevation myocardial infarction treated with sirolimus-eluting stents

• Published in: Coronary artery disease Vol. 20; no. 6; p. 422
• Main Authors: Yoshikawa, Daiji, Isobe, Satoshi, Umeda, Hisashi, Kawai, Tomoko, Shimizu, Takeshi, Yamashita, Kentaro, Ishii, Hideki, Murohara, Toyoaki
• Format: Journal Article
• Language: English
• Published: England 01.09.2009
• Subjects: Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - mortality; Asian Continental Ancestry Group; Cardiovascular Agents - administration & dosage; Coronary Angiography; Drug-Eluting Stents; Female; Humans; Japan; Kaplan-Meier Estimate; Male; Metals; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - ethnology; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Platelet Aggregation Inhibitors - therapeutic use; Proportional Hazards Models; Prosthesis Design; Recurrence; Risk Assessment; Risk Factors; Sirolimus - administration & dosage; Stents; Thrombosis - etiology; Time Factors; Treatment Outcome
• ISSN: 1473-5830
• DOI: 10.1097/MCA.0b013e32832fa92c

The long-term prognosis of Japanese ST-elevation myocardial infarction (STEMI) patients treated with sirolimus-eluting stents (SESs) still remains unclear. We aimed to determine the 3-year outcomes of this population. Major adverse cardiac events (MACE) defined as all-cause death, reinfarction, and target vessel revascularization during 3 years, angiographic data, and events of stent thrombosis were compared between 95 consecutive STEMI patients treated with SESs and 94 treated with bare-metal stents (BMSs). Significant advantages were discerned in all follow-up angiographic data from the SES group. The rate of target vessel revascularization was significantly less in the SES group than in the BMS group (P = 0.006). There was no significant difference in the rates of mortality (P = 0.258) or reinfarction (P = 0.496). The Kaplan-Meier analysis showed that at a 3-year follow-up, MACE-free survival was significantly higher in the SES group than in the BMS group (log-rank P<0.001). Academic Research Consortium 'definite' or 'probable' stent thrombosis was observed in two patients ('early' and 'very late') in the SES group and no patient in the BMS group. We observed no significant difference in the event rates of stent thrombosis (2.1% SES group vs. 0% BMS group, P = 0.497). In Japanese STEMI patients, a 3-year follow-up showed that the routine use of SESs reduces the incidence of MACE without increasing the risk of stent thrombosis.