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Impact of direct stenting on clinical outcomes for small vessel coronary artery disease in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction.
- Source :
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Postepy w kardiologii interwencyjnej = Advances in interventional cardiology [Postepy Kardiol Interwencyjnej] 2019; Vol. 15 (4), pp. 404-411. Date of Electronic Publication: 2019 Dec 08. - Publication Year :
- 2019
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Abstract
- Introduction: Direct stenting (DS) is associated with improved markers of reperfusion during primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). However, data evaluating its impact in small vessel coronary artery disease (CAD) are lacking.<br />Aim: To compare DS and conventional stenting (CS) for small vessel CAD on clinical outcomes of patients with STEMI undergoing PPCI.<br />Material and Methods: A cohort of 616 STEMI patients treated with DS (202 patients) or CS (414 patients) in small vessel (≤ 2.75 mm) lesions was retrospectively analyzed. The primary endpoint was to compare the occurrence of major adverse cardiac events (MACE) between groups during 2-year follow-up. The secondary end points included in-hospital target lesion revascularization (TLR) and in-hospital death.<br />Results: The primary end-point, MACEs, occurred in 9.2% in the DS group and 12.3% in the CS group ( p > 0.05). The rates of TLR, myocardial infarction (MI) and target vessel revascularization (TVR) were not significantly different between groups ( p > 0.05). The stent thrombosis (ST) rate was significantly lower in the DS group (1.0% vs. 4.2%, p = 0.04) at 2 years. However, DS was not found to be an independent predictor of ST in multivariate analysis. There were no significant differences in in-hospital rates of death and TLR. The DS compared to CS resulted in greater rates of postprocedural TIMI grade 3 flow, and lower risk of edge dissection. The procedure time, radiation exposure and contrast administration were found to be significantly lower in the DS group.<br />Conclusions: In selected patients with STEMI undergoing PPCI for small vessel CAD, DS is not only safe and feasible but also reduces ST rates, contrast load, and procedural and radiation exposure time.<br />Competing Interests: The authors declare no conflict of interest.<br /> (Copyright: © 2019 Termedia Sp. z o. o.)
Details
- Language :
- English
- ISSN :
- 1734-9338
- Volume :
- 15
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Postepy w kardiologii interwencyjnej = Advances in interventional cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 31933656
- Full Text :
- https://doi.org/10.5114/aic.2019.90214