Direct stenting is an independent predictor of improved survival in patients undergoing primary percutaneous coronary

Related Experiment Video

Updated: May 1, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

27.4K

Liam M McCormick1, Adam J Brown1, Liam S Ring1

  • 1Department of Cardiology, Papworth Hospital, UK.

European Heart Journal. Acute Cardiovascular Care
|April 11, 2014
PubMed

Insights

Direct stenting (DS) in primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) significantly reduces 30-day and one-year mortality compared to predilatation (PD) stenting. This improved survival is independent of other interventions.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Previous randomized trials indicated direct stenting (DS) improves reperfusion markers in primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI).
  • Limited data exist on the long-term clinical outcome impact of DS versus predilatation (PD) stenting in STEMI patients.

Purpose of the Study:

  • To evaluate the effect of DS on mortality in a contemporary, unselected STEMI population undergoing PPCI.
  • To compare the long-term survival rates between DS and PD stenting strategies.

Main Methods:

  • Analysis of 1562 consecutive STEMI patients undergoing PPCI at two UK centers (September 2008 - December 2010).
  • Data collected on patient demographics, PPCI strategy (DS vs. PD, manual thrombus aspiration, glycoprotein IIb/IIIa inhibitors).
  • In-hospital, 30-day, and one-year mortality assessed using national databases; multivariate logistic analysis performed for one-year survival.

Main Results:

  • Direct stenting (DS) was used in 31.3% of patients (n=489); predilatation (PD) in 68.7% (n=1073).
  • DS group showed significantly lower 30-day (2.04% vs. 4.66%, p=0.01) and one-year mortality (3.27% vs. 8.48%, p=0.0001).
  • After multivariate adjustment, PD remained an independent predictor of one-year mortality (OR 2.42, p=0.032); neither glycoprotein IIb/IIIa inhibitors nor manual thrombus aspiration improved survival.

Conclusions:

  • In contemporary STEMI patients undergoing PPCI, direct stenting (DS) is independently associated with improved 30-day and one-year survival compared to stenting after predilatation (PD).
  • The findings support the adoption of DS as a preferred strategy in PPCI for STEMI to enhance long-term patient outcomes.
Abstract

Keywords:
Primary percutaneous coronary interventionST elevation myocardial infarctiondirect stentingmortalitypredilatation

More Related Videos

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

2.8K
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

11.1K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
2.1K
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
444
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
522
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
495