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Bare-Metal Stents Versus Drug-Eluting Stents for Primary Angioplasty: Long-Term Outcome

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Abstract

Percutaneous transluminal coronary intervention (PCI) is the most used myocardial revascularization technique for patients with coronary artery disease. Primary PCI with stent implantation is widely considered the gold standard for the treatment of ST-elevation myocardial infarction patients. Coronary stents, compared with balloon angioplasty, have reduced focal lesion restenosis. To reduce in-stent restenosis, drug-eluting stents (DES) were designed to locally release drugs inhibiting neointimal growth. Recent concerns have emerged on the potential higher risk of stent thrombosis with DES that might be even more pronounced among myocardial infarction patients. For these reasons, DES for primary PCI remains an “off-label” use. In the last several years, a number of randomized trials and registries have tested the safety and efficacy of DES in primary PCI. Data from these studies were analyzed in several meta-analyses, reasonably consistently demonstrating that the use of DES significantly decreased the need for revascularization without an increase in the incidence of death, recurrent infarction, or stent thrombosis at long-term follow-up.

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Abbreviations

COMPARE:

Second-Generation Everolimus-Eluting and Paclitaxel-Eluting Stents in Real-Life Practice

HORIZONS-AMI:

Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction

PASEO:

Paclitaxel or Sirolimus-Eluting Stent Versus Bare Metal Stent in Primary Angioplasty

PASSION:

Paclitaxel-Eluting Stent Versus Conventional Stent in Myocardial Infarction with ST-Segment Elevation

RAVEL:

Randomized, Double-Blind Study with the Sirolimus Eluting BX Velocity Balloon Expandable Stent in the Treatment of Patients with De Novo Coronary Artery Lesions

SESAMI:

Sirolimus Stent Versus Bare Stent in Acute Myocardial Infarction

SIRIUS:

Sirolimus-Eluting Stent in De Novo Native Coronary Lesions

STRATEGY:

Single High-Dose Bolus Tirofiban and Sirolimus Eluting Stent Versus Abciximab and Bare Metal Stent in Myocardial Infarction

TYPHOON:

Trial to Assess the Use of the CYPHER® Stent in Acute Myocardial Infarction Treated with Balloon Angioplasty

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Authors and Affiliations

  1. Laboratory of Cardiac Catheterization and Interventional Cardiology, Department of Cardiology and Cardiovascular Surgery, A.O.R.N “San G. Moscati”, Avellino, Italy

    Emilio Di Lorenzo, Giannignazio Carbone, Luigi Sauro, Alfredo Casafina, Michele Capasso & Rosario Sauro

  2. Laboratorio di Emodinamica e, Cardiologia Interventistica, A.O.R.N. San G. Moscati, Contrada Amoretta, 83100, Avellino, Italy

    Emilio Di Lorenzo

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  1. Emilio Di Lorenzo
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  2. Giannignazio Carbone
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  3. Luigi Sauro
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  5. Michele Capasso
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Correspondence to Emilio Di Lorenzo.

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Di Lorenzo, E., Carbone, G., Sauro, L. et al. Bare-Metal Stents Versus Drug-Eluting Stents for Primary Angioplasty: Long-Term Outcome. Curr Cardiol Rep 13, 459–464 (2011). https://doi.org/10.1007/s11886-011-0207-0

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