Long-term outcome after drug eluting stenting in patients with ST-segment Elevation Myocardial Infarction Data from the REAL Registry Gianluca Campo a, ⁎ , Francesco Saia b , Gianfranco Percoco a , Antonio Manari c , Andrea Santarelli d , Luigi Vignali e , Elisabetta Varani f , Alberto Benassi g , Pietro Sangiorgio h , Fabio Tarantino i , Paolo Magnavacchi j , Rossana De Palma k , Paolo Guastaroba k , Antonio Marzocchi b a Unità Operativa di Cardiologia, Azienda Ospedaliera Universitaria S. Anna, Ferrara, Italy b Istituto di Cardiologia, Università di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy c Unità Operativa di Cardiologia Interventistica, Ospedale S. Maria Nuova, Reggio Emilia, Italy d Unità Operativa di Cardiologia, Ospedale degli Infermi, Rimini, Italy e Divisione di Cardiologia, Ospedale Maggiore, Parma, Italy f Unità Operativa di Cardiologia, Ospedale S. Maria delle Croci, Ravenna, Italy g Laboratorio di Emodinamica, Hesperia Hospital, Modena, Italy h Divisione di Cardiologia, Ospedale Maggiore, Bologna, Italy i Unità di Cardiologia, Ospedale Morgagni, Forlì, Italy j Nuovo Ospedale S. Agostino, Modena, Italy k Agenzia Sanitaria Regionale Regione Emilia-Romagna Bologna, Bologna, Italy Received 15 June 2008; received in revised form 21 October 2008; accepted 1 November 2008 Available online 3 December 2008 Abstract Background: The long-term safety and efficacy of drug eluting stents (DES) implanted during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is unclear. The purpose of this study was to compare the long-term outcome of STEMI patients undergoing primary PCI with DES vs. bare metal stent (BMS) implantation. Methods: In the present analysis 4764 patients were enrolled (706, 15%, received DES). We assessed the cumulative incidence of major adverse cardiac events (MACE) and stent thrombosis (ST). Results: Overall, no significant difference emerged for the rates of death and reinfarction. DES implantation was associated to a reduction of target vessel revascularization (TVR) (HR 0.65, 95%CI 0.47–0.91; p = 0.01), leading to a MACE reduction (HR 0.7, 95%CI 0.56–0.86; p b 0.01). In particular, during the first 2 years we observed less adverse events in the DES group, mainly because of a lower TVR rate (TVR: HR 0.56, 95%CI 0.37–0.83, p b 0.01; MACE: HR 0.71, 95%CI 0.54–0.94, p =0.01). On the contrary, during the third year, adverse events tended to be higher in the DES group. ST did not differ between DES and BMS groups (p = 0.6). No differences were observed between sirolimus eluting stents and paclitaxel eluting stents. Conclusions: DES implantation during primary PCI is safe and associated with a significant TVR and MACE reduction in the first two years, whereas a trend to have more adverse events in the third year is observed. More data about long-term follow-up are needed to better evaluate both safety and efficacy of DES in the setting of STEMI. © 2008 Elsevier Ireland Ltd. All rights reserved. Keywords: Primary percutaneous coronary intervention; Drug eluting stent; Stent thrombosis; Clinical outcome; Acute myocardial infarction International Journal of Cardiology 140 (2010) 154 – 160 www.elsevier.com/locate/ijcard ⁎ Corresponding author. Cardiovascular Institute, Azienda Ospedaliera Universitaria S. Anna, Corso Giovecca 203, 44100 Ferrara (Italy). Tel.: +39 0532 202143; fax: +39 0532 241885. E-mail address: cmpglc@unife.it (G. Campo). 0167-5273/$ - see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2008.11.021