Delayed Stenting for ST-Elevation Acute Myocardial Infarction in Daily Practice: A Single-Centre Experience

Area of Science:

• Cardiology
• Interventional Cardiology
• Acute Coronary Syndromes

Background:

• The minimalist immediate mechanical intervention (MIMI) strategy aims to restore normal blood flow while deferring stent implantation.
• This study evaluates the applicability and midterm outcomes of MIMI for ST-elevation myocardial infarction (STEMI).

Purpose of the Study:

• To assess the feasibility and clinical results of the MIMI strategy in STEMI management.
• To compare MIMI with immediate stenting in a real-world setting.

Main Methods:

• An observational study of consecutive STEMI patients admitted within 24 hours.
• Comparison of "intentional immediate stenting" versus "intentional delayed stenting" (MIMI technique).

Main Results:

• The MIMI strategy was used in 20% of patients, who were younger, more often male, and smokers.
• MIMI group had a 1.8% acute reocclusion rate, less frequent culprit lesion stenting (28.5% vs 9%), and more drug-eluting stent use (52% vs 27%).
• One-year survival free from major adverse cardiovascular events was significantly higher in the MIMI group (96.3% vs 83.8%).

Conclusions:

• The MIMI strategy is applicable in selected STEMI patients.
• MIMI is associated with reduced stenting and increased drug-eluting stent use, leading to better midterm outcomes.
• Further evaluation in randomized trials is warranted.