Key result
Sirolimus-eluting stents significantly reduced major adverse cardiac events at 8 months compared to bare-metal stents (9.7% vs 27.1%) in patients with acute coronary syndrome undergoing emergency PCI.
Why the study?
Does sirolimus-eluting stent implantation reduce major adverse cardiac events compared to bare-metal stents in patients with acute coronary syndrome undergoing emergency PCI?
Observational (n=154)
Does sirolimus-eluting stent implantation reduce major adverse cardiac events compared to bare-metal stents in patients with acute coronary syndrome undergoing emergency PCI?
Absolute Event Rate: 9.7% vs 27.1%
p-value: p=0.01
In patients with acute coronary syndrome undergoing emergency PCI, sirolimus-eluting stents significantly reduced 8-month major adverse cardiac events and repeat revascularization compared to bare-metal stents, without increasing the risk of stent thrombosis.
Sirolimus-eluting stents were associated with lower MACE in ACS emergency PCI; hypothesis-generating and requires randomized confirmation before practice change.
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 3.04 mm vs BMS 3.24 mm; p=0.01) and longer stent length (25.7 mm vs 21.2 mm; 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.
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Nomoto et al. (2008) conducted an observational in Acute Coronary Syndrome (n=154). Sirolimus-eluting stent (SES) vs. Bare-metal stent (BMS) was evaluated on Major adverse cardiac events (MACE) at 8 months (p=0.01). Sirolimus-eluting stents significantly reduced major adverse cardiac events at 8 months compared to bare-metal stents (9.7% vs 27.1%) in patients with acute coronary syndrome undergoing emergency PCI.
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