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ACC: Drugs Effective in ST-Segment Elevation Heart Attack

Eluting stents better than uncoated stents for reducing cardiac events

MONDAY, March 31 (HealthDay News) -- In patients undergoing percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI), tirofiban and abciximab treatment are similarly effective at resolving ST-segment elevation, while sirolimus-eluting stents are superior to uncoated stents in reducing major cardiac events, according to a report published online March 30 in the Journal of the American Medical Association and presented at the American College of Cardiology's 57th Scientific Session this week in Chicago.

Marco Valgimigli, M.D., Ph.D., from the University of Ferrara in Italy, and colleagues randomly assigned 745 patients undergoing percutaneous coronary intervention for STEMI to abciximab with an uncoated stent, abciximab with a sirolimus-eluting stent, tirofiban with an uncoated stent, or tirofiban with a sirolimus-eluting stent.

The researchers found that similar percentages of patients in the abciximab and tirofiban groups had ST-segment elevation resolution at 90 minutes (83.6 versus 85.3 percent, relative risk 1.02), with similar ischemic and hemorrhagic outcomes in both groups. At eight months, significantly fewer patients receiving sirolimus-eluting stents had a major cardiac event compared with patients receiving uncoated stents (7.8 versus 14.5 percent, respectively), primarily due to reduced revascularization rates (3.2 versus 10.2 percent, respectively).

"In patients with STEMI undergoing percutaneous coronary intervention, compared with abciximab, tirofiban therapy was associated with non-inferior resolution of ST-segment elevation at 90 minutes following coronary intervention, whereas sirolimus-eluting stent implantation was associated with a significantly lower risk of major adverse cardiac events than uncoated stents within eight months after intervention," Valgimigli and colleagues conclude.

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