Post-discharge clinical and angiographic outcomes of patients presenting within 48 h of STEMI treated with paclitaxel- or sirolimus-eluting stents

Abstract Background and purpose The purpose of the present study was to examine the mid-term clinical and angiographic outcomes of patients with ST-segment elevation myocardial infarction (STEMI) who presented within 48 h and received paclitaxel-eluting stents (PES) or sirolimus-eluting stents (SES). Methods and results This study was a retrospective, non-randomized, single-center study. The post-discharge clinical outcomes of 357 consecutive patients who presented within 48 h of their first STEMI and received PES ( n = 163) or SES ( n = 194) between February 2007 and February 2009 were analyzed in May 2011. The incidence of post-discharge events (i.e. cardiac death and non-fatal recurrent MI) after PES placement (0.6%) did not significantly differ from that after SES placement (1.5%). Treatment with PES was not related to the risk of adverse events post-discharge (mean follow-up period for PES placement, 1170 ± 243 days; hazard ratio, 0.346; 95% CI, 0.036–3.371; p = 0.361). No definite stent thromboses developed after treatment with PES or SES. The incidence of binary in-stent restenosis (stenosis of more than 50% of the diameter at secondary angiography performed 10–18 months after the initial procedure) after PES placement (17.1%) was significantly higher than that after SES placement (4.8%; p < 0.001). PES placement was an independent predictor of binary in-stent restenosis (odds ratio, 3.892; 95% CI, 1.470–10.30; p = 0.006). Conclusions Retrospective examination of the post-discharge clinical course after placement of PES and SES showed favorable midterm clinical outcomes among Japanese STEMI patients treated within 48 h of onset. However, SES treatment resulted in superior angiographic outcomes compared to PES.