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  • Title: Long-term outcome after drug-eluting versus bare-metal stent implantation in patients with ST-segment elevation myocardial infarction: 3-year follow-up of the randomized DEDICATION (Drug Elution and Distal Protection in Acute Myocardial Infarction) Trial.
    Author: Kaltoft A, Kelbaek H, Thuesen L, Lassen JF, Clemmensen P, Kløvgaard L, Engstrøm T, Bøtker HE, Saunamäki K, Krusell LR, Jørgensen E, Tilsted HH, Christiansen EH, Ravkilde J, Køber L, Kofoed KF, Terkelsen CJ, Helqvist S.
    Journal: J Am Coll Cardiol; 2010 Aug 17; 56(8):641-5. PubMed ID: 20688033.
    Abstract:
    OBJECTIVES: The purpose of this study was to compare long-term clinical outcomes after implantation of drug-eluting stents (DES) and bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: The evidence of long-term efficacy and safety after implantation of DES in patients with complex lesions is scarce. METHODS: We randomly assigned 626 patients with STEMI referred within 12 h to have a DES or a BMS implanted in the infarct-related lesion with or without distal protection during primary percutaneous coronary intervention. RESULTS: At 3 years, target lesion revascularization was 6.1% in the DES group compared with 16.3% in the BMS group (p<0.001), and the rate of major adverse cardiac events was 11.5% versus 18.2%, respectively (p=0.02). Whereas all-cause mortality did not differ significantly, the rate of cardiac death was higher in the DES group, 6.1% versus 1.9% for the BMS group (p=0.01). The occurrence of reinfarction, stroke, and stent thrombosis was similar. CONCLUSIONS: Implantation of DES in patients with STEMI reduces the long-term rate of major adverse cardiac events compared with BMS, but patients with DES had a higher risk of cardiac death not attributed to myocardial infarction or stent thrombosis. (Drug Elution and Distal Protection During Percutaneous Coronary Intervention in ST Elevation Myocardial Infarction [DEDICATION]; NCT00192868)
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