Mid-term angiographic benefit of sirolimus-eluting stents compared with paclitaxel-eluting stents in patients with acute myocardial infarction

Background: We compared angiographic and clinical outcomes among different drug-eluting stents (DESs) in Korean acute myocardial infarction (AMI) patients. Methods: A total of 109 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) with either sirolimus-eluting (SES, n = 56 pts) or paclitaxel-eluting stents (PIES, n = 53 pts) were enrolled from August 2004 to December 2006. The angiographic outcomes at 6 months and clinical outcomes at 1 year were compared between the two groups. Results: Baseline clinical and procedural characteristics were similar between the two groups. At 6 months, the rate of binary restenosis was 17.0% in the PIES group compared with 3.6% in the SES group (p=0.026). Percent restenosis was 24.9 +/- 28.6% in the PES group compared with 11.2 +/- 17.6% in the SES group (p = 0.004). Length of restenosis segment was 3.21 +/- 9.02 mm in the PIES group compared with 0.89 +/- 2.38 mm in the SES group (p = 0.048). Late toss was 0.73 +/- 0.89 mm in the PIES group compared with 0.28 +/- 0.37 mm in the SES group (p = 0.001). However, there were no differences in clinical outcomes at 1 year including mortality, myocardial infarction, repeat PCI, and major cardiac adverse events between two groups. Conclusion: SES implantation in patients with AMI was associated with reduction in angiographic restenosis at 6 months compared with PES, however, these angiographic benefits were not translated into better clinical outcomes in real world clinical practice. (C) 2009 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved.