In their recently published article De Luca and coworkers aimed to perform an updated meta-analysis to evaluate the benefits of coronary stenting for acute myocardial infarction (AMI) in terms of mortality, reinfarction, and target vessel revascularization (TVR), and whether these benefits correlated with the patient's risk profile [1]. In that meta-regression analysis, a total of 13 randomized trials were identified and analyzed involving 6922 patients (50% randomized to stent and 50% randomized to balloon). They found that among AMI patients undergoing primary percutaneous intervention (PCI), coronary stent implantation, when anatomically and technically feasible, may be considered, in addition to benefits in terms of TVR, to reduce mortality in high-risk patients, who may be identified by the use of validated risk scores [1]. Initial nonrandomized studies suggesting that primary stenting was more effective in ST segment elevation myocardial infarction (STEMI) than primary PTCA [2,3] were followed by randomized trials [4–7]. A 2005 metaanalysis evaluated 9 randomized trials with a total of 4433 patients [8]. In that meta-analysis stenting was shown to be associated with significant reductions in reinfarction (odds ratio [OR] 0.52, 95% CI 0.31–0.87 at 30 days, and OR 0.67, 95% CI 0.45–0.98 at 1 year) and TVR (OR 0.45, 95% CI 0.34–0.60 at 30 days, and OR 0.47, 95% CI 0.38–0.57 at 1 year). However, there was no significant difference in mortality (OR 1.06 at 1 year). The Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial randomly assigned 2082 patients with AMI to PTCA alone, PTCA and abciximab, stenting alone, or stenting and abciximab; clopidogrel or ticlopidine was given to all patients initially and then continued in those who received a stent [4]. Thus, CADILLAC examined 2 issues: stenting versus PTCA; and abciximab versus no therapy. The initial restoration of TIMI grade 3 blood flow was comparable in all groups (94.5 to 96.9%). At 6 months, the composite end point (death, reinfarction, disabling stroke, or ischemia-driven TVR) was significantly lower with stenting compared to PTCA alone (10.5 versus 18.0%). The benefit of stenting was entirely due to a significantly lower need for repeat ischemia-driven revascularization. There was no difference in mortality among groups. Stenting was associated with a lower rate of angiographic restenosis (22 versus 41%) and reocclusion of the infarct-related artery (5.7 versus 11%); these changes were independent of abciximab use. The Primary Angioplasty in Myocardial Infarction Study (Stent PAMI) trial randomly assigned 900 patients with an AMI to primary PTCA or implantation of a heparin-coated Palmaz–Schatz stent [5]. Angiographic success was high in both groups, but the minimum luminal diameter was significantly larger with stenting (2.56 versus 2.12 mm for PTCA). At 30 days, the composite end point (death, recurrent MI, stroke, or ischemia-driven target vessel revascularization) was similar in both groups (4.2 versus International Journal of Cardiology 133 (2009) 394–423 www.elsevier.com/locate/ijcard