Impact of multiple stent implantation on periprocedural myocardial infarction in patients undergoing planned pci in a clinically stable setting: insights from a single-centre cohort study.

INTRODUCTION: Acute coronary syndrome (ACS) is a critical cardiovascular emergency frequently treated with percutaneous coronary intervention (PCI). Despite its benefits, PCI is associated with a substantial risk of periprocedural myocardial infarction (PMI), particularly among patients receiving multiple stents. This study aims to explore the incidence and determinants of PMI in ACS patients undergoing planned PCI in a clinically stable setting. METHODS: This retrospective single-center study enrolled ACS patients undergoing planned PCI in a clinically stable setting between June 2018 and August 2022. Patients were classified into single-stent (SSG) and multi-stent (MSG) groups. PMI was defined by Academic Research Consortium-2 criteria, and multivariable logistic regression was used to identify factors associated with PMI. RESULTS: A total of 330 patients with ACS were initially screened, and 222 were ultimately included, comprising 126 in the single-stent group (SSG) and 96 in the multi-stent group (MSG). PMI occurred more frequently in the MSG than in the SSG (16.7% vs. 7.9%, p = 0.045). Compared with the SSG, the MSG had fewer single-vessel lesions, more left circumflex artery involvement, and larger stent diameters, indicating greater lesion and procedural complexity. Multivariable logistic regression showed that both AMI (OR = 2.804, 95% CI: 1.122-7.010; p = 0.027) and a higher number of implanted stents (OR = 2.533, 95% CI: 1.012-6.340; p = 0.047) were associated with PMI. CONCLUSION: Multiple stent implantation during planned PCI is associated with a higher risk of PMI. Careful procedural planning may help reduce PMI incidence in patients with complex coronary anatomy.