Cardiac Outcomes Similar Among Patients With Drug-Eluting and Bare-Metal Stents

A recent study showed that 1-year outcomes are similar among patients who receive drug-eluting stents vs those who receive bare-metal stents following acute myocardial infarction (AMI) with cardiogenic shock (CS).

Few prior studies have compared drug-eluting stents with bare-metal stents in patients with AMI with CS. Therefore, the researchers sought to further explore patient outcomes with both stent technologies.
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The researchers evaluated 652 patients with AMI and CS undergoing early revascularization in the Intra-aortic Balloon Pump in Cardiogenic Shock II trial (n = 600) and the associated registry (n = 183). Patients receiving both stents or no stents at all were excluded from the analysis. The researchers defined the primary outcome as the composite of 1-year mortality or another AMI event.

Of the 652 patients included in the analysis, 276 (42%) had received a drug-eluting stent, and 376 (58%) had received bare-metal stents.

Results indicated that there was no significant difference between drug-eluting stents and bare-metal stents in relation to 1-year mortality or re-AMI, after adjusting for baseline characteristics.

The researchers found an independent association of use of bare-metal stents with older age, atrial fibrillation, and coronary single-vessel disease, while use of drug-eluting stents was associated with prior history of dyslipidaemia, baseline hemoglobin level, anterior AMI, and treatment at frequently enrolling centers.

“Despite the frequent use of [drug-eluting stents] nowadays, a substantial number of patients were treated by [bare-metal stents] in AMI complicated by CS,” the researchers concluded. “After adjustment for risk factors, the 1-year outcome of patients treated by [drug-eluting stents] compared with [bare-metal stents] was similar.”

—Christina Vogt

Reference:

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(15):1146-1147. doi: 10.1136/heartjnl-2016-311146.