Related Experiment Video

Updated: Sep 14, 2025

Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

22.0K

Deferred Versus Immediate Stenting in Late-Presenting ST-Segment Elevation Myocardial Infarction (STEMI) Patients

Ahmed Hesham Hammad1, Mahmoud Abdelaziz Ismaiel2, Mohammed H Abd-Elnaby1

  • 1Cardiology, Faculty of Medicine, Mansoura University, Mansoura, EGY.

Cureus
|July 21, 2025
PubMed

Insights

Deferred stenting improves outcomes for high-risk patients with late ST-segment elevation myocardial infarction (STEMI) and high thrombus burden (HTB). This approach leads to better myocardial perfusion and fewer adverse cardiovascular events compared to immediate stenting.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Late-presenting ST-segment elevation myocardial infarction (STEMI) is a high-risk condition.
  • Patients with high thrombus burden (HTB) face increased risks with immediate stenting.
  • Optimal stent timing in this subgroup is not well-defined.

Purpose of the Study:

  • To compare the efficacy of deferred stenting versus immediate stenting.
  • To evaluate outcomes in late-presenting STEMI patients with HTB.
  • To determine the optimal stent timing strategy for this patient population.

Main Methods:

  • Retrospective study of 200 late-presenting STEMI patients with HTB.
  • Comparison of deferred stenting (DS) group (n=100) versus immediate stenting (IS) group (n=100).
  • Assessment of myocardial perfusion (MBG, TIMI flow) and one-year MACE.

Main Results:

  • Deferred stenting significantly reduced no-reflow and distal embolization.
  • Higher rates of TIMI grade 3 flow and MBG 3 were observed in the DS group.
  • One-year MACE was significantly lower in the DS group (7% vs. 20%).

Conclusions:

  • Deferred stenting is superior to immediate stenting in late-presenting STEMI patients with HTB.
  • This strategy improves myocardial perfusion and reduces adverse cardiovascular events.
  • Individualized stent timing is crucial for this high-risk patient subgroup.
Abstract

Keywords:
high thrombus burdenlate presentationmajor adverse cardiac events (mace)primary percutaneous coronary intervention (pci)st-elevation myocardial infarction (stemi)

More Related Videos

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.4K
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

9.4K

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...
80
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...
23
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
45
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...
30
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
47