Why the study?
Do drug-eluting stents reduce repeat revascularization without increasing death, recurrent MI, or stent thrombosis compared to bare-metal stents in patients with STEMI?
Do drug-eluting stents reduce repeat revascularization without increasing death, recurrent MI, or stent thrombosis compared to bare-metal stents in patients with STEMI?
Review of evidence suggests DES reduce repeat revascularization without increasing mortality or stent thrombosis compared to BMS in STEMI patients, including in Japanese populations.
Supports DES consideration in STEMI to curb repeat revascularization; extends prior reviews but leaves open need for updated RCTs.
The effective use of drug-eluting stents (DES) in the treatment of ST-elevation myocardial infarction (STEMI), a condition representative of acute coronary syndrome, has not been clarified, particularly among Japanese patients. The indication of DES for STEMI patients is discussed by reviewing the evidence from both Western countries and Japan. Currently, in the registry studies, randomized studies, and meta-analyses comparing the use of DES and bare-metal stents (BMS) in STEMI patients, DES show a consistent trend toward decreasing the risk of repeat revascularization without increasing the incidence of death, recurrent MI or stent thrombosis when compared with BMS in the treatment for patients with STEMI. Japanese data are also consistent with this trend. However, there are no clear data indicating safety concerns. Longer-term follow-up studies are necessary to assess the effectiveness of DES in STEMI patients.
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Yoshihisa Nakagawa (2010) studied this question.
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