Study of efficacy and safety of drug eluting stent versus bare metal stent in ST elevation MI

Vijay P. Bakhtar, Niyati V. Bakhtar, Sameer P. Chaudhari


Background: The present study was conducted with the aim of determining whether drug-elutingstents are superior to uncoated stents in the setting of primaryPCI in terms of occurrence of serious adverse cardiac events.

Methods: In this prospective, single blind, randomized study, 20 to 80 years old patients with acute myocardial infarction with ST-segment elevation with >30 minutes of chest pain and at least 1 mm of ST-segment elevation in at least two standard leads or a new LBBB or 2 mm of ST-segment elevation in at least two contiguous leads were included. Patients were randomly assigned to receive either drug eluting stent (DES) (Everolimus Eluting stent, Endevour-Medtronics) or bare metal stent (BMS, Cordis-Dx sonic) in a 1:1 ratio. During follow ups at 30 days and 12 months, all serious adverse cardiac events like death from cardiac or non-cardiac cause, recurrent MI, revascularization of target vessel, coronary artery bypass grafting (CABG) or other intervention to target or non-target vessel etc. were recorded and compared between groups.

Results: No significant differences were found between the two treatmentgroups for occurrence of adverse events during first 30 days after the intervention. At one year follow-up, trends were observed in favorof the DES group, none of the differences weresignificant.

Conclusions: No significant benefit was observed with the use of Everolimus-eluting stents in primaryPCI for acute myocardial infarction with ST-segment elevation,in comparison with baremetal stents.


Adverse events, Bare metal stent, Drug eluting stent, STEMI

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WHO fact sheet No WF. 310. Available at: Accessed on 10th March 2019.

Reddy KS, Shah B, Varghese C, Ramadoss A. Responding to the threat of chronic diseases in India. The Lancet. 2005;366(9498):1744-9.

Xavier D, Pais P, Devereaux PJ, Xie C, Prabhakaran D, Reddy KS, et al. Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. The Lancet. 2008;371(9622):1435-42.

Gruentzig AR. Transluminal dilatation of coronary artery stenosis. Lancet. 1978;1:263.

Serruys PW, Kutryk MJ, Ong AT. Coronary-artery stents. New Eng J Med. 2006:354(5):483-95.

Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, et al, 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am College Cardiol. 2016;67(10):1235-50.

Suryapranata H, De Luca G, Van’t Hof AW, Ottervanger JP, Hoorntje JC, et al. Is routine stenting for acute myocardial infarction superior to balloon angioplasty? A randomised comparison in a large cohort of unselected patients. Heart. 2005;91(5):641-5.

Tomas FL, Steffel J, Eberli FR. Drug–Eluting Stent and Coronary Thrombosis: Biological Mechanism and Clinical Implications. Circulation. 2007:1051-8.

Daemen J, Wenaweser P, Tsuchida K, Abrecht L, Vaina S, Morger C, et al. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. The Lancet. 2007;369(9562):667-78.

Park DW, Park SW, Park KH, Lee BK, Kim YH, Lee CW, Hong MK, Kim JJ, Park SJ. Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J cardiol. 2006;98(3):352-6.

Laarman GJ, Suttorp MJ, Dirksen MT, van Heerebeek L, Kiemeneij F, Slagboom T, et al. Paclitaxel-eluting versus uncoated stents in primary percutaneous coronary intervention. New Eng J Med. 2006;355(11):1105-13.

Spaulding C, Henry P, Teiger E, Beatt K, Bramucci E, Carrié D, et al. Sirolimus-eluting versus uncoated stents in acute myocardial infarction. New Eng J Med. 2006;355(11):1093-104.

Valgimigli M, Percoco G, Malagutti P, Campo G, Ferrari F, Barbieri D, et al. Tirofiban and sirolimus-eluting stent vs abciximab and bare-metal stent for acute myocardial infarction: a randomized trial. JAMA 2005;293:2109–2117.

TIMI Study Group*. The Thrombolysis in Myocardial Infarction (TIMI) trial: phase I findings. New Eng J Med. 1985;312(14):932-6.

Dibra A, Kastrati A, Alfonso F, Seyfarth M, Pérez-Vizcayno MJ, Mehilli J, et al. Effectiveness of drug-eluting stents in patients with bare-metal in-stent restenosis: meta-analysis of randomized trials. J Am College Cardiol. 2007;49(5):616-23.

Kastrati A, Mehilli J, Pache J, Kaiser C, Valgimigli M, Kelbæk H, et al. Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. New Eng J Med. 2007;356(10):1030-9.

Stone GW, Grines CL, Cox DA, Garcia E, Tcheng JE, Griffin JJ, et al. Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. New Eng J Med. 2002;346(13):957-66.

Van de werf F, Baim DS. Reperfusion for ST-segment elevation myocardial infarction; an overview of current treatment options. Circulation 2002;105:2813.