Mid-term angiographic benefit of sirolimus-eluting stents compared with paclitaxel-eluting stents in patients with acute myocardial infarction

Background: We compared angiographic and clinical outcomes among different drug-eluting stents (DESs) in Korean acute myocardial infarction (AMI) patients. Methods: A total of 109 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) with either sirolimus-eluting (SES, n = 56 pts) or paclitaxel-eluting stents (PES, n = 53 pts) were enrolled from August 2004 to December 2006. The angiographic outcomes at 6 months and clinical outcomes at 1 year were compared between the two groups. Results: Baseline clinical and procedural characteristics were similar between the two groups. At 6 months, the rate of binary restenosis was 17.0% in the PES group compared with 3.6% in the SES group (p = 0.026). Percent restenosis was 24.9 ± 28.6% in the PES group compared with 11.2 ± 17.6% in the SES group (p = 0.004). Length of restenosis segment was 3.21 ± 9.02 mm in the PES group compared with 0.89 ± 2.38 mm in the SES group (p = 0.048). Late loss was 0.73 ± 0.89 mm in the PES group compared with 0.28 ± 0.37 mm in the SES group (p = 0.001). However, there were no differences in clinical outcomes at 1 year including mortality, myocardial infarction, repeat PCI, and major cardiac adverse events between two groups. Conclusion: SES implantation in patients with AMI was associated with reduction in angiographic restenosis at 6 months compared with PES, however, these angiographic benefits were not translated into better clinical outcomes in real world clinical practice.