Drug eluting stents should be used with caution in acute myocardial infarction
This analysis used the database from the Global Registry of Acute Coronary syndromEs (GRACE), collected in 94 hospitals in 14 countries across 4 continents (Americas, Europe, Australia/NZ) to compare the survival up to 2 years of patients treated with bare metal stents only or receiving at least one drug eluting stent.
Survival appeared similar in the 6-months following discharge, but thereafter mortality was greater in patients treated with drug eluting stents. This difference was entirely related to patients treated for acute myocardial infarction and was associated with an increased risk of late reinfarction, suggesting that it may indeed be related to late stent thrombosis.
Although caution should always be exercised when analysing an observational study such as GRACE (in which patients who received drug eluting stents and bare metal stents were not similar), this survival difference (which persists after statistical adjustment for the differences in baseline characteristics between the two types of patients) suggests that DES should be used with caution in patients with acute myocardial infarction, at least until more evidence is accumulated of their long term safety from large studies with long term follow up.
The GRACE registry is supported by sanofi-aventis and has been ongoing since 1999.
The coordinating center is at the Center for Outcomes Research,
University of Massachusetts Medical School
365 Plantation Street, Suite 185
Worcester, MA 01605
Phone: (508) 856-2275
Fax: (508) 856-5159
Notes to editors:
This study was presented at the ESC Congress 2007 in Vienna.
The European Society of Cardiology (ESC)
The ESC represents nearly 53,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
The ESC achieves this through a variety of scientific and educational activities including the coordination of: clinical practice guidelines, education courses and initiatives, pan-European surveys on specific disease areas and the ESC Annual Congress, the largest medical meeting in Europe. The ESC also works closely with the European Commission and WHO to improve health policy in the EU.
The ESC comprises 3 Councils, 5 Associations, 19 Working Groups, 50 National Cardiac Societies and an ESC Fellowship Community (Fellow, FESC; Nurse Fellow, NFESC). For more information on ESC Initiatives, Congresses and Constituent Bodies see www.escardio.org.
European Society of Cardiology, The European Heart House 2035 Route des Colles, B.P. 179 - Les Templiers, Sophia Antipolis F-06903 France
About the Author(s)
Professor Ph. Gabriel Steg
Hôpital Bichat-Claude Bernard, Paris, France
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