Safety and Efficacy of Sirolimus-Eluting Stent in Patients With Acute Coronary Syndrome Undergoing Emergency Procedure

概要

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Background Sirolimus-eluting stents (SES) reduce restenosis and revascularization rates, compared with bare-metal stents (BMS), in elective percutaneous coronary intervention (PCI). This study investigated the safety and efficacy of SES for emergency PCI in acute coronary syndrome (ACS) patients. Methods and Results The 154 consecutive patients (SES: n=77, BMS: n=77) admitted to hospital with ACS were enrolled in this study. Procedural success (%DS<50%, Thrombolysis In Myocardial Infarction grade 3), major adverse cardiac events (MACE) at 30 days and 8 months, and the incidence of stent thrombosis were evaluated. There was no difference between the groups regarding procedural success. Patients treated with SES had smaller stent diameter (SES 3.04mm vs BMS 3.24mm; p=0.01) and longer stent length (25.7mm vs 21.2mm; p=0.01). At 30 days, there was no difference between the groups in the incidence of cardiovascular events. At 8 months, patients treated with the SES had a lower rate of repeat PCI (5.6% vs 18.6%; p=0.04) and MACE (9.7% vs 27.1%; p=0.01). Stent thrombosis was no different between groups (1.4% vs 2.9%). Conclusion In emergency PCI for ACS patients, SES implantation significantly reduced cardiovascular events, compared with BMS, by decreasing the incidence of repeat PCI. The safety profile of SES is equal to that of BMS.
社団法人日本循環器学会の論文
2008-06-20