Comparative study between immediate and deferred stenting in patients with st-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Backgroundand aim In ST-elevation myocardial infarction (STEMI) patients with a large thrombus burden, no or slow-reflow signals poor outcomes. This study aimed to compare outcomes of immediate stent (IS) implantation in primary percutaneous coronary intervention against deferred stenting (DS) in STEMI. Patients and methods Our study was a prospective interventional study conducted on 100 patients presenting with STEMI for primary percutaneous coronary intervention. Patients were divided into two groups according to the timing of stent implantation, the IS group (52 patients) and the deferred stent group (48 patients) according to operators’ preferences depending on thrombus burden and vascular status. Results In-hospital arrhythmia was higher in the DS group (47.9%) compared with the IS group (30.8%), without a significant difference. Complete ST-segment resolution 60 min after PCI was significantly more in the DS group ( P =0.034). Hospital stay was significantly higher in the DS group. The mean left ventricular (LV) ejection fraction was 46.83±5.8% in the IS group compared with 46.38±6.7 in the deferred stent group. There was no significant difference between the groups regarding major adverse cardiac events. Absolute change (improvement) in LV ejection fraction was significantly more in the DS group compared with the IS group ( P =0.025). Conclusion Based on the current study, the DS approach is fairly better than IS as regards angiographic outcomes, complete ST resolution, and improved LV systolic function after 3 months.