Clinical Research in Cardiology

, Volume 99, Issue 6, pp 345–357

Drug-eluting stents in acute myocardial infarction: updated meta-analysis of randomized trials

  • Alban Dibra
  • Klaus Tiroch
  • Stefanie Schulz
  • Henning Kelbæk
  • Christian Spaulding
  • Gerrit J. Laarman
  • Marco Valgimigli
  • Emilio Di Lorenzo
  • Christoph Kaiser
  • Ilkka Tierala
  • Julinda Mehilli
  • Gianluca Campo
  • Leif Thuesen
  • Maarten A. Vink
  • Martin J. Schalij
  • Roberto Violini
  • Albert Schömig
  • Adnan Kastrati
Review

DOI: 10.1007/s00392-010-0133-y

Cite this article as:
Dibra, A., Tiroch, K., Schulz, S. et al. Clin Res Cardiol (2010) 99: 345. doi:10.1007/s00392-010-0133-y

Abstract

Background

Use of drug-eluting stents in patients with acute myocardial infarction (AMI) remains an “off label” indication due to concerns regarding their performance in this patient subset.

Methods

We searched Medline, the Cochrane Central Register of Controlled Trials, and Internet-based sources of information on clinical trials in cardiology for randomized trials comparing drug-eluting stents with bare-metal stents in patients with AMI. Hazard ratios for the composite of death or recurrent myocardial infarction, (primary safety endpoint), reintervention (primary efficacy endpoint), death, recurrent myocardial infarction, and stent thrombosis were calculated performing a meta-analysis of 14 randomized trials with 7,781 patients.

Results

There was no difference in the hazard of death or recurrent myocardial infarction (hazard ratio, 0.91; [95% CI 0.75–1.09]) between patients treated with drug-eluting stents versus patients treated with bare-metal stents. Treatment with drug-eluting stents resulted in a significant reduction in the hazard of reintervention (0.41 [95% CI 0.32–0.52]). The hazards of death (0.90 [95% CI 0.71–1.15]), myocardial infarction (0.81 [95% CI 0.63–1.04]), and stent thrombosis (0.84 [95% CI 0.61–1.17]) were not significantly different between patients treated with drug-eluting stents versus patients treated with bare-metal stents.

Conclusions

Use of drug-eluting stents in patients with AMI is safe and markedly reduces the need for reintervention as compared to bare-metal stents.

Keywords

Myocardial infarctionAngioplastyDrug-eluting stentsRestenosisThrombosis

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Alban Dibra
    • 1
  • Klaus Tiroch
    • 1
  • Stefanie Schulz
    • 1
  • Henning Kelbæk
    • 2
  • Christian Spaulding
    • 3
  • Gerrit J. Laarman
    • 4
  • Marco Valgimigli
    • 5
  • Emilio Di Lorenzo
    • 6
  • Christoph Kaiser
    • 7
  • Ilkka Tierala
    • 8
  • Julinda Mehilli
    • 1
  • Gianluca Campo
    • 5
  • Leif Thuesen
    • 9
  • Maarten A. Vink
    • 10
  • Martin J. Schalij
    • 11
  • Roberto Violini
    • 12
  • Albert Schömig
    • 1
  • Adnan Kastrati
    • 1
  1. 1.Deutsches HerzzentrumTechnische UniversitätMunichGermany
  2. 2.RigshospitaletUniversity of CopenhagenCopenhagenDenmark
  3. 3.Assistance Publique-Hôpitaux de Paris (AP-HP), Cochin HospitalParis 5 Medical School Rene Descartes University and INSERM U780-AvenirParisFrance
  4. 4.King’s College HospitalLondonUK
  5. 5.University of FerraraFerraraItaly
  6. 6.A.O.R.N. “S. G. Moscati”AvellinoItaly
  7. 7.University of BaselBaselSwitzerland
  8. 8.Helsinki University Central HospitalHelsinkiFinland
  9. 9.Skejby SygehusSkejbyDenmark
  10. 10.Onze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  11. 11.Leiden University Medical CenterLeidenThe Netherlands
  12. 12.San Camillo HospitalRomeItaly