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

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.