Volume 3, Issue 5, September 2014, Page: 125-129
Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
Roman S. Tarasov, Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Vladimir I. Ganyukov, Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Alexey V. Protopopov, Department of interventional cardiology, Krasnoyarsk Regional Hospital, Krasnoyarsk, Russia
Olga L. Barbarash, Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Leonid S. Barbarash, Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Received: Aug. 6, 2014;       Accepted: Aug. 23, 2014;       Published: Aug. 30, 2014
DOI: 10.11648/j.cmr.20140305.12      View  2958      Downloads  158
Abstract
Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.
Keywords
ST-Elevation Myocardial Infarction, Primary Percutaneous Coronary Intervention, Multivessel Coronary Artery Disease, Second Generation Drug-Eluting Stents
To cite this article
Roman S. Tarasov, Vladimir I. Ganyukov, Alexey V. Protopopov, Olga L. Barbarash, Leonid S. Barbarash, Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents, Clinical Medicine Research. Vol. 3, No. 5, 2014, pp. 125-129. doi: 10.11648/j.cmr.20140305.12
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