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World J Cardiol. Sep 26, 2014; 6(9): 929-938
Published online Sep 26, 2014. doi: 10.4330/wjc.v6.i9.929
Drug-eluting stents and acute myocardial infarction: A lethal combination or friends?
Shuji Otsuki, Manel Sabaté
Shuji Otsuki, Manel Sabaté, Thorax Institute, Department of Cardiology, Hospital Clinic, University of Barcelona, 08015 Barcelona, Spain
Author contributions: All authors contributed to this work.
Correspondence to: Manel Sabaté, MD, PhD, Thorax Institute, Department of Cardiology, Hospital Clinic, University of Barcelona, C/Villaroel 170, 08036 Barcelona, Spain. masabate@clinic.ub.es
Telephone: +34-93-2275400 Fax: +34-93-2279305
Received: February 10, 2014
Revised: March 12, 2014
Accepted: July 17, 2014
Published online: September 26, 2014
Abstract

Primary percutaneous coronary intervention is the preferred reperfusion strategy for patients presenting with ST-segment elevation myocardial infarction (STEMI). First generation drug-eluting stents (DES), (sirolimus drug-eluting stents and paclitaxel drug-eluting stents), reduce the risk of restenosis and target vessel revascularization compared to bare metal stents. However, stent thrombosis emerged as a major safety concern with first generation DES. In response to these safety issues, second generation DES were developed with different drugs, improved stent platforms and more biocompatible durable or bioabsorbable polymeric coating. This article presents an overview of safety and efficacy of the first and second generation DES in STEMI.

Keywords: ST-segment elevation myocardial infarction, Drug-eluting stents, Stent thrombosis, Sirolimus drug-eluting, Paclitaxel drug-eluting stents, Zotarolimus-eluting stents, Zotarolimus-eluting stents, Bioresorbable vascular scaffold

Core tip: Primary percutaneous coronary intervention is the preferred reperfusion strategy for patients presenting with ST-segment elevation myocardial infarction (STEMI). First-generation drug-eluting stents (DES) reduce restenosis and target vessel revascularization compared to bare metal stents at the expense of an increased stent thrombosis rate. Recent improvements in second-generation DES have overcome these safety concerns. This article presents an overview of safety and efficacy of the DES in STEMI.