Should we routinely use drug-eluting stents for acute myocardial infarction? Let's wait and see.

ow quickly time flies! It has now been a decade since eporting the first randomized trial of coronary stenting for cute myocardial infarction (AMI). At that time, it was hocking to think that one could place a metal foreign body nto a thrombogenic milieu and expect the artery to remain atent. Hence, we and others conducted several randomized rials comparing primary angioplasty and stenting, and arefully excluded lesions at high risk of thrombosis (large hrombus, no reflow), utilized stents with heparin coatings 1), and optimized the antithrombotic strategy (2). These 13 andomized AMI trials showed that compared with percuaneous transluminal coronary angioplasty for AMI, bareetal stents (BMS) reduced restenosis and target vessel evascularization (TVR) but did not improve mortality (3) r ventricular function (1,2). Based on improved angioraphic results and reductions in acute and long-term schemia, BMS quickly became the standard of care for MI patients.