Drug eluting stents are associated with reduced mortality in patients with myocardial infarction at two years
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
March 30, 2008 By Vijayalakshmi Kunadian MBBS MD MRCP [1]
SCAI-ACCi2 08-Chicago, IL: Investigators from Boston reported today that the use of drug-eluting stents is associated with reduced mortality at two years compared with bare metal stents among patients with both ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI).
Dr. Laura Mauri from Harvard Clinical Research Institute, Boston MA, presented the results at the SCAI-I2 summit Annual Scientific Sessions in Chicago today.
Although many randomized controlled studies have evaluated the use of drug-eluting stents (DES) in the absence of an acute myocardial infarction, few studies have evaluated their use in the setting of an infarct (both in the setting of a STEMI and NSTEMI). Therefore Dr. Mauri and colleagues from Boston studied patients who underwent percutaneous coronary intervention (PCI) with stenting for acute myocardial infarction between April 1 2003 and September 30, 2004. They collected information from the Massachusetts state database which monitors quality of care from all acute care non-US governmental hospitals in Massachusetts. This study grouped patients who received DES and bare metal stents (BMS) both in the setting of NSTEMI and STEMI.
In total there were 7216 patients who were treated with stenting in the setting of an infarct with both DES (n=4016) and BMS (n=3200). A total of 3835 patients underwent treatment for NSTEMI with DES or BMS (50.7% vs. 49.3%, p<0.0001) and 3381 patients underwent treatment for STEMI with DES or BMS (46.2% vs. 53.8%, p<0.001).
Among patients who received DES compared with those who received BMS there was a significant reduction in the unadjusted cumulative overall mortality for all patients (9% vs. 14%, p<0.001) at two years. The risk adjusted two year mortality rates were also significantly reduced for all patients (10.6% vs. 13.4%, p=0.002) at two years among those who received DES vs. BMS.
The investigators also demonstrated a significant reduction in the need for revascularization for all MI patients (p<0.001) both separately for patients with NSTEMI (p<0.001) and STEMI (p<0.001) for DES compared with BMS. Similarly, there was a significant reduction in the need for target vessel revascularization for all patients (p<0.001) both separately for patients with NSTEMI (p=0.02) and STEMI (p=0.002) at two years among those who received DES vs. BMS, respectively.
The authors concluded that the use of DES is associated with reduced mortality at two years among patients with an acute infarct and there is a reduced need for repeat target vessel revascularization in the setting of both STEMI and NSTEMI.
Source
Late Breaking Clinical Trials Session: SCAI Annual Scientific Sessions in partnership with ACC i2 summit, March 30, 2008 Chicago
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
