Key result
Implantation of ≥ 2 stents in the infarct-related artery did not significantly affect one-year all-cause mortality compared to a single stent in patients with STEMI undergoing primary PCI (10.3% vs 8.3%, p=0.37).
Why the study?
Does the implantation of ≥ 2 stents in the infarct-related artery increase the risk of adverse clinical outcomes at one year in patients with STEMI undergoing primary PCI?
Observational (n=1,741)
Yes
Does the implantation of ≥ 2 stents in the infarct-related artery increase the risk of adverse clinical outcomes at one year in patients with STEMI undergoing primary PCI?
Absolute Event Rate: 10.3% vs 8.3%
p-value: p=0.37
In STEMI patients undergoing primary PCI, the need for multiple stents in the infarct-related artery is associated with an increased risk of stent thrombosis and urgent revascularization at one year.
Multiple stents in STEMI primary PCI were associated with higher thrombosis risk; leaves open causal role versus lesion complexity.
BACKGROUND AND AIM: We sought to evaluate the impact of multiple stent implantation in the infarct-related artery (IRA) on one-year clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: Data on 1741 consecutive patients with STEMI, who underwent immediate PCI with implantation of ≥ 1 stent, enrolled the National Registry of Drug Eluting Stents (NRDES) were assessed. Patients were stratified based on the number of implanted stents in IRA: 1 vs. ≥ 2 stents. At the discretion of operators, ≥ 2 stents in IRA were implanted in 247 (14.2%) patients. The remaining 1494 patients were treated with a single stent. Patients treated with multiple stents were less likely to achieve Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow after primary PCI. Overall mortality at one year was 8.3% in the single stent group and 10.3% in the ≥ 2 stents group (p = 0.37; adjusted for propensity score p = 0.13). After propensity score matching, patients treated with ≥ 2 stents were at higher risk of definite or probable stent thrombosis and urgent revascularisation at one year. CONCLUSIONS: In patients with STEMI undergoing primary PCI, a need for implantation of ≥ 2 stents in IRA carries an increased risk of stent thrombosis and urgent revascularisation at one year.
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Dziewierz et al. (2016) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=1,741). Implantation of ≥ 2 stents in the infarct-related artery vs. Implantation of a single stent was evaluated on One-year all-cause mortality (p=0.37). Implantation of ≥ 2 stents in the infarct-related artery did not significantly affect one-year all-cause mortality compared to a single stent in patients with STEMI undergoing primary PCI (10.3% vs 8.3%, p=0.37).
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