Comparative analysis of DES vs. bare metal stents for the treatment of STEMI- acute and mid-term outcomes

ABSTRACT

The use of drug eluting stents (DES) in primary percutaneous intervention(PCI) remains controversial. We sought to evaluate the acute and midterm (1year) safety and efficacy of DES versus bare metal stents (BMS) in the treatmentof acute STEMI.Methods and results: We enrolled 240 patients from two different institutions,one public (which only uses BMS because of government heathy policy) and oneprivate (that uses DES as the standard option for PCI), with acute STEMI whoundergone primary PCI. The primary end point was in hospital and 1 year rates ofmajor adverse cardiac events (MACE), defined as death, myocardial infarction(MI) and target lesion revascularisation (TLR). The clinical profile of patientsenrolled in the BMS group (n=169 pts) was more complex with higher incidence ofhypertension (73.3% vs. 60.5% p=0.06), previous MI (34.3% vs. 15.5% p<0.01),chronic renal insufficiency ( 26% vs. 12,8% p=0,03) and previous CABG (11.8%vs. 1,41% p=0,01). Also, patients in the BMS cohort had significant more PCIperformed by radial approach (20.7% vs. 0% p<0.01) while in the DES group thenumber of stents per patient was significantly higher...