Clinical Outcomes of Direct or Direct like Stenting in Patients Undergoing Primary Pci for Stemi

Background Significant Improvement in reperfusion markers is observed by direct stenting (DS) in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention. However, clinical outcomes are variable, and information on the number of patients with STEMI who can be treated with DS or direct-like stenting is lacking. Aim To determine the feasibility and clinical outcomes of DS or direct-like stenting in patients with acute STEMI Methods This single-center and retrospective clinical study analyzed data from 514 patients admitted to the hospital with STEMI from October 2016 to March 2021. Most of these patients were treated with DS or direct-like stenting, and the operator was as direct as possible in performing the procedure. The outcomes were noted at the 2-year follow-up, and the incidence of on-table complications was analyzed. Results The total motality was 11.2% and the major adverse cardiac events (MACE) were seen in 13.62% at the 2-year follow-up. The post-procedural thrombolysis in myocardial infarction grade 3 flow was achieved in >86% of patients. A lower risk of edge dissection was observed. Our study revealed that DS reduced radiation exposure time, procedure time, and contrast volume used. Patients with cardiogenic shock have worst outcomes than patients with normal hemodynamics. It is a well-known fact that the cardiogenic shock patients have worst outcomes than normal hemodynamic patients. We analyzed this group of patients separately, so as to see the still better outcomes with DS in this high-risk sub-set of patients. Conclusions Study results demonstrated that DS or direct-like stenting is a quite promising method in most patients with STEMI and causes fewer on-table complications. Additionally, it supports the hypothesis that DS may result in better 2-year follow-up results.