RT Journal
A1 Brophy JM, MEng, MD, PhD
T1 Drug-eluting stents in st-segment elevation myocardial infarction: Comment on “drug-eluting vs bare-metal stents in primary angioplasty”
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2012
FD April 23
VO 172
IS 8
SP 621
OP 622
DO 10.1001/archinternmed.2012.694
UL http://dx.doi.org/10.1001/archinternmed.2012.694
AB 
In this issue of the Archives, De Luca et al1 and the Drug-Eluting Stent in Primary Angioplasty (DESERT) Cooperation have performed a meta-analysis of the long-term (3- to 6-year) results from 11 randomized clinical trials (RCTs) comparing drug-eluting stents (DES) with bare-metal stents (BMS) in ST-segment elevation myocardial infarction (STEMI). They observed that DES implantation reduced the occurrence of target-vessel revascularization (TVR) by 43% (12.7% [DES] vs 20.1% [BMS]; hazard ratio [HR], 0.57 [95% CI, 0.50-0.66]), without any significant overall difference in terms of mortality, reinfarction, and stent thrombosis. However, the landmark analysis revealed a statistically significant increase with DES in the risk of very late (>1 year) reinfarction (6.6% [DES] vs 3.0% [BMS]; HR, 1.57 [95% CI, 1.08-2.27]) and stent thrombosis (3.1% [DES] vs 1.4%, [BMS]; HR, 1.89 [95% CI, 1.13-3.15]). Despite these worrisome findings, the authors conclude that this study provides reassurance that the DES benefits in STEMI warrant the potential risks.