OBJECTIVES: We sought to evaluate the impact of direct stenting technique on angiographic and clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty (PCI). METHODS: Data on 1,419 patients who underwent immediate PCI for STEMI with implantation of ≥1 stent within native coronary artery were retrieved from the EUROTRANSFER Registry database. Patients were stratified based on the stent implantation technique: direct (without predilatation) vs. conventional stenting. Propensity score adjustment was used to control possible selection bias. RESULTS: Direct stenting technique was used in 276 (19.5%) patients. Remaining 1,143 patients were treated with stent implantation after balloon predilatation. Direct compared with conventional stenting resulted in significantly greater rates of postprocedural TIMI grade 3 flow (conventional vs. direct stenting: 91.5% vs. 94.9%, adjusted OR 2.09 (1.13-3.89), P = 0.020), and lower risk of no-reflow (3.4% vs. 1.4%, adjusted OR 0.31 (0.10-0.92), P = 0.035). The rates for ST-segment resolution >50% after PCI were higher in patients treated with direct stenting technique (76.3% vs. 86.2%, adjusted OR 1.64 (1.10-2.46), P = 0.016). A significant reduction in 1-year mortality in patients from the direct stenting group compared with the conventional stenting group, even after adjustment for propensity score was observed (6.5% vs. 2.9%, adjusted OR 0.45 (0.21-0.99), P = 0.047). CONCLUSIONS: When anatomically and technically feasible, the use of direct stenting technique may result in improved long-term survival in patients with STEMI undergoing primary PCI.
OBJECTIVES: We sought to evaluate the impact of direct stenting technique on angiographic and clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty (PCI). METHODS: Data on 1,419 patients who underwent immediate PCI for STEMI with implantation of ≥1 stent within native coronary artery were retrieved from the EUROTRANSFER Registry database. Patients were stratified based on the stent implantation technique: direct (without predilatation) vs. conventional stenting. Propensity score adjustment was used to control possible selection bias. RESULTS: Direct stenting technique was used in 276 (19.5%) patients. Remaining 1,143 patients were treated with stent implantation after balloon predilatation. Direct compared with conventional stenting resulted in significantly greater rates of postprocedural TIMI grade 3 flow (conventional vs. direct stenting: 91.5% vs. 94.9%, adjusted OR 2.09 (1.13-3.89), P = 0.020), and lower risk of no-reflow (3.4% vs. 1.4%, adjusted OR 0.31 (0.10-0.92), P = 0.035). The rates for ST-segment resolution >50% after PCI were higher in patients treated with direct stenting technique (76.3% vs. 86.2%, adjusted OR 1.64 (1.10-2.46), P = 0.016). A significant reduction in 1-year mortality in patients from the direct stenting group compared with the conventional stenting group, even after adjustment for propensity score was observed (6.5% vs. 2.9%, adjusted OR 0.45 (0.21-0.99), P = 0.047). CONCLUSIONS: When anatomically and technically feasible, the use of direct stenting technique may result in improved long-term survival in patients with STEMI undergoing primary PCI.
Authors: Mahmoud Khaled Nour; Hany Tawfik Fathelbab; Ahmad Hosam Mwafy; Mohamad Ashraf Shawky; Santiago Jesús Camacho Freire; Javier León Jiménez; Jessica Roa Garrido; Antonio Enrique Gómez Menchero; Rosa Cardenal Piris; José Francisco Díaz Fernández; Samir ELhadidy Tawfik Journal: Open Access Maced J Med Sci Date: 2019-08-14
Authors: Livio Giuliani; Federico Archilletti; Giuseppe Andò; Serena Rossi; Giorgio Sacchetta; Giuseppe De Iaco; Francesco Saporito; Marco Contarini; Rosario Parisi; Sabina Gallina; Marco Zimarino; Juan Luis Gutiérrez-Chico; Nicola Maddestra Journal: Cardiol J Date: 2021-05-04 Impact factor: 2.737