Author Affiliations: Deutsches Herzzentrum, Technische Universität, Munich, Germany.
Over the past 2 decades, numerous randomized trials have been performed to define the optimal reperfusion therapy in patients with acute ST-segment elevation myocardial infarction (STEMI). An analysis of 23 randomized trials has assessed the relative merits of primary percutaneous coronary intervention (PCI) vs thrombolysis in approximately 8000 patients with STEMI and demonstrated a clear advantage for PCI.1 Fewer trials were required to establish the implantation of bare-metal stents (BMSs) compared with plain balloon-angioplasty as the first-choice PCI option in these patients.2 More recently, assessment of the role of drug-eluting stents (DESs) during primary PCI has drawn considerable attention with approximately 10 000 patients with acute myocardial infarction (AMI) enrolled in randomized trials comparing DESs with BMSs in the last decade alone.3,4 Indeed, in no other setting has DES use elicited as much skepticism as in patients with STEMI.
Cassese S, Kastrati A. New-Generation Drug-Eluting Stents for Patients With Myocardial Infarction. JAMA. 2012;308(8):814-815. doi:10.1001/2012.jama.10465