Outcomes With Various Drug-Eluting or Bare Metal Stents in Patients With ST-Segment–Elevation Myocardial Infarction A Mixed Treatment Comparison Analysis of Trial Level Data From 34 068 Patient-Years of Follow-Up From Randomized Trials

Background—The efficacy and safety of drug-eluting stents (DES) in patients with ST-segment–elevation myocardial infarction (STEMI) is controversial. Consequently, DES implantation has a class IIa indication in the American College of Cardiology/American Heart Association and the European Society of Cardiology STEMI guidelines. Methods and Results—PUBMED, EMBASE, and CENTRAL were searched for randomized clinical trials, until March 2013, comparing any of the 5 Food and Drug Administration–approved durable stent and polymer DES (sirolimus eluting stent, paclitaxel eluting stent, everolimus-eluting stent [EES], zotarolimus-eluting stent, and zotarolimus-eluting stent resolute), against each other or bare metal stents (BMS), and enrolling ≥50 patients with STEMI. Efficacy (target vessel revascularization) and safety (death, myocardial infarction, and stent thrombosis) outcomes at the longest reported follow-up times were evaluated. Twenty-eight randomized clinical trials with 34 068 patient-years of follow-u...