ESC Congress 2007 Press Releases - Steg DES MI hotline III

ESC Congress 2007 Press Releases - Steg DES MI hotline III


Drug eluting stents should be used with caution in acute myocardial infarction

Authors:
Professor Ph. Gabriel STEG

Hôpital Bichat-Claude Bernard, Paris, FranceMobile: +33 60 724 62 24Fax: +33 140 25 88 5E-mail: gabriel.steg@bch.aphp.fr

Hot line III, Increased all-cause mortality at 2 year follow-up after PCI with drug-eluting stents vs bare metal stents in acute coronary syndromes: the GRACE registry experience, 709.

Vienna, Austria, September 4 2007: Drug-eluting stents are extremely effective devices to prevent restenosis following angioplasty. Yet, since last year, there is some debate and persistent uncertainty regarding the long term safety of these devices. Specifically, there is concern that some of these stents may occlude abruptly more than 1 year after placement, due to “late stent thrombosis”. Although this is a rare event (probably in the range of less than 1% per year) it is extremely severe, with patients dying in up to 45% of those cases. Therefore, there is concern that this rare but life-threatening event may offset the benefit achieved by drug-eluting stents in preventing restenosis.


The risk of such late stent thrombosis may be greater in the context of acute coronary syndromes and, in fact, little information is available so far from rigorous randomized clinical trials comparing drug eluting stents and the more conventional bare metal stents, in the context of acute coronary syndromes, particularly in the context of acute myocardial infarction. The randomized clinical trials which have compared drug-eluting stents and bare metal stents in the context of acute myocardial infarction are relatively small (totalling less than 1,000 patients with drug eluting stents) and most have only reported one year of follow-up.