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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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[Comparison of Direct Stenting Versus Stending After Pre-Dilation in ST-Elevation Myocardial Infarction]

V A Kuznetsov1, I S Bessonov1, I P Zyrianov1

  • 1"Tyumen Cardiology Science Center", Branch of the Federal State Budgetary Science Institution "Tomsk National Research Medical Center of the Russian Academy of Sciences".

Kardiologiia
|December 26, 2017
PubMed

Insights

Direct coronary stenting (DS) showed comparable in-hospital outcomes to stenting after predilation (PD) in ST-elevation myocardial infarction (STEMI) patients. This study compared major adverse cardiac events (MACE) between the two primary PCI strategies.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical condition requiring timely reperfusion therapy.
  • Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for STEMI.
  • The optimal stenting technique, direct stenting (DS) versus stenting after predilation (PD), remains an area of investigation.

Purpose of the Study:

  • To compare in-hospital outcomes of DS versus PD in STEMI patients undergoing primary PCI.
  • To evaluate major adverse cardiac events (MACE), including death, myocardial infarction, and stent thrombosis.
  • To identify predictors of the no-reflow phenomenon in this patient cohort.

Main Methods:

  • Retrospective analysis of 1103 STEMI patients undergoing primary PCI from 2006 to 2014.
  • Comparison of clinical and angiographic characteristics between DS (n=563) and PD (n=540) groups.
  • Assessment of in-hospital MACE and analysis of no-reflow predictors.

Main Results:

  • No significant difference in MACE was observed between DS and PD groups.
  • Patients in the DS group were younger (57.9 vs 60 years) and had less chronic kidney disease (5.2% vs 8.4%).
  • The DS group more frequently received prehospital thrombolysis (25% vs 11.9%).

Conclusions:

  • Direct stenting is a safe and effective strategy for STEMI patients undergoing primary PCI.
  • The choice between DS and PD may depend on patient characteristics and procedural factors.
  • Further research is warranted to explore long-term outcomes and specific patient subgroups.
Abstract

Keywords:
direct stentingmyocardial infarctionprimary percutaneous coronary interventions

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