Stent choice in cardiogenic shock complicating acute myocardial infarction likely does not affect mortality or reinfarction

Commentary on:  Ledwoch J, Fuernau G, Desch S, et al . Drug-eluting stents versus bare-metal stents in acute myocardial infarction with cardiogenic shock. Heart 2017;103:1177–84. Early revascularisation improves acute and long-term outcomes of patients presenting with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS). However, which type of stent to use for revascularisation remains controversial. Earlier small single-centre non-randomised study and registry data concluded that a drug-eluting stent (DES) is superior to a bare metal stent (BMS) as it improved clinical outcomes in these patients.1 2 Current European Society Guidelines recommend the use of DES, while American Society guidelines do not. This study examined the impact of BMS versus DES use on clinical outcomes in patients who had participated in the previously reported the Intra-aortic Balloon Pump (IABP) in Cardiogenic Shock II Trial (IABP-SHOCK II) which showed …