open access

Vol 74, No 8 (2016)
Original articles
Published online: 2016-01-26
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The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry

Artur Dziewierz, Zbigniew Siudak, Tomasz Rakowski, Wojciech Zasada, Jacek Legutko, Anna Żabówka, Łukasz Partyka, Dariusz Dudek
DOI: 10.5603/KP.a2016.0020
·
Kardiol Pol 2016;74(8):717-725.

open access

Vol 74, No 8 (2016)
Original articles
Published online: 2016-01-26

Abstract

Background and aim: We sought to evaluate the impact of multiple stent implantation in the infarct-related artery (IRA) on one-year clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

Methods and results: Data on 1741 consecutive patients with STEMI, who underwent immediate PCI with implantation of ≥ 1 stent, enrolled the National Registry of Drug Eluting Stents (NRDES) were assessed. Patients were stratified based on the number of implanted stents in IRA: 1 vs. ≥ 2 stents. At the discretion of operators, ≥ 2 stents in IRA were implanted in 247 (14.2%) patients. The remaining 1494 patients were treated with a single stent. Patients treated with multiple stents were less likely to achieve Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow after primary PCI. Overall mortality at one year was 8.3% in the single stent group and 10.3% in the ≥ 2 stents group (p = 0.37; adjusted for propensity score p = 0.13). After propensity score matching, patients treated with ≥ 2 stents were at higher risk of definite or probable stent thrombosis and urgent revascularisation at one year.

Conclusions: In patients with STEMI undergoing primary PCI, a need for implantation of ≥ 2 stents in IRA carries an increased risk of stent thrombosis and urgent revascularisation at one year.

Abstract

Background and aim: We sought to evaluate the impact of multiple stent implantation in the infarct-related artery (IRA) on one-year clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

Methods and results: Data on 1741 consecutive patients with STEMI, who underwent immediate PCI with implantation of ≥ 1 stent, enrolled the National Registry of Drug Eluting Stents (NRDES) were assessed. Patients were stratified based on the number of implanted stents in IRA: 1 vs. ≥ 2 stents. At the discretion of operators, ≥ 2 stents in IRA were implanted in 247 (14.2%) patients. The remaining 1494 patients were treated with a single stent. Patients treated with multiple stents were less likely to achieve Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow after primary PCI. Overall mortality at one year was 8.3% in the single stent group and 10.3% in the ≥ 2 stents group (p = 0.37; adjusted for propensity score p = 0.13). After propensity score matching, patients treated with ≥ 2 stents were at higher risk of definite or probable stent thrombosis and urgent revascularisation at one year.

Conclusions: In patients with STEMI undergoing primary PCI, a need for implantation of ≥ 2 stents in IRA carries an increased risk of stent thrombosis and urgent revascularisation at one year.

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Keywords

primary angioplasty, drug-eluting stent, bare-metal stent, ST elevation myocardial infarction

About this article
Title

The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 74, No 8 (2016)

Pages

717-725

Published online

2016-01-26

DOI

10.5603/KP.a2016.0020

Bibliographic record

Kardiol Pol 2016;74(8):717-725.

Keywords

primary angioplasty
drug-eluting stent
bare-metal stent
ST elevation myocardial infarction

Authors

Artur Dziewierz
Zbigniew Siudak
Tomasz Rakowski
Wojciech Zasada
Jacek Legutko
Anna Żabówka
Łukasz Partyka
Dariusz Dudek

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