The impact of multiple overlapping new generations drug-eluting stents on six-month clinical outcomes in patients with anterior STEMI treated with primary PCI
Background: Implantation of multiple (≥ 2) overlapping stents has been associated with adverse outcomes after percutaneous coronary intervention (PCI). However, data regarding the impact of multiple new generations drug-eluting stents (DES) during primary PCI (PPCI) are limited.
Objective: To evaluate the impact of multiple overlapping stents implantation on the 6-months clinical outcomes of anterior STEMI patients undergoing PPCI with new generations DES.
We evaluated a total of 1078 consecutive anterior STEMI patients who underwent PPCI with deployment of new generations DES. The patients were divided according to the number of implanted stents into 2 groups; multiple-stents group having ≥2 overlapping stents (n =388) and single-stent group (n =690). We compared the rates of major adverse cardiovascular events (MACEs; composite of cardiac death, reinfarction, ischemia-driven target vessel revascularization (TVR), definite stent thrombosis (ST), and stroke) between the 2 study groups.
There was a non-significant trend toward increased in-hospital mortality in the multiple-stents group [3.4% vs 1.7%; P=0.096] related to a significant higher rate of cardiogenic shock [9.5% vs 6.1%; P=0.037] and post-procedural suboptimal TIMI flow [26.3% vs 19.4%; P=0.009] as compared to the single-stent group. Yet, there were no significant differences between the 2 groups in the incidence of 6-month MACEs: [9% vs 7.1%; P=0.259], cardiac death: [4.6% vs 3%; P=0.173], reinfarction: [3.6% vs 3.2%; P=713], TVR: [4.4% vs 4.1%; P=0.799], and definite ST: [3.6% vs 2.8%; P=0.43], respectively.
The use of multiple new generations DES, if needed, is relatively safe and acceptable during PPCI for STEMI patients.
Karim Elakabawi, Jiahao Feng, Hameed Ullah, Wael Tawfik, Mohamed Mahrous, Mohamed Salem, Ning Guo, Zuyi Yuan. The impact of multiple overlapping new generations drug-eluting stents on six-month clinical outcomes in patients with anterior STEMI treated with primary PCI. Cardiometry; Issue 17; November 2020; p.76-84; DOI: 10.12710/cardiometry.2020.17.7684; Available from: http://www.cardiometry.net/issues/no17-november-2020/drug-eluting-stents