Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: We would like to raise some
points regarding the report of the STRATEGY trial by Dr Valgimigli and colleagues.1 The study compared adjuvant tirofiban plus sirolimus-eluting
stenting vs abciximab plus bare-metal stenting in the context of acute ST-segment
elevation myocardial infarction (STEMI) and found no significant differences
in the rate of major adverse cardiovascular events at 30 days. However, target
vessel revascularization (TVR) and target lesion revascularization were significantly
less frequent in the tirofiban plus sirolimus-eluting stent group at 8 months,
a finding that also drove the reduction in major adverse cardiovascular events
for that group. The strategy of using different glycoprotein IIb/IIIa receptor
antagonists in the 2 groups was based on the higher cost implications of abciximab
(compared with tirofiban) and drug-eluting stents.
Osman F, Qaisar S, El Gaylani N, Pitt M. Tirofiban Plus Sirolimus-Eluting Stent vs Abciximab Plus Bare-Metal
Stent. JAMA. 2005;294(13):1616-1618. doi:10.1001/jama.294.13.1616