Two preventive multivessel stenting strategy with zotarolimus eluting stents in STelevation myocardial infarction patients: 12-month results of randomized trial

Abstract

Background: Preventive 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) is unresolved and controversial issue of contemporary interventional cardiology. Twelve-month results of our randomized trial (NCT01781715) presented. Methods and findings: One-year outcomes of 136 consecutive patients with STEMI and multivessel coronary artery disease (MVCAD) (SYNTAX Score 18.9±7.7 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity™ Stent, Medtronic) were evaluated. The patients were randomized into two groups of preventive multivessel stenting: Multivessel primary stenting (MPS primary, n=67) (the infarct-related artery (IRA) and non-IRA stenting during one PCI) and multivessel stenting in staged revascularisation (MSS, n=69) (the IRA only stenting during the primary PCI and non-IRA stenting during the same hospital period (10.1±5.1 days between PCIs). Over the 12-month observation there were no differences in adverse cardiovascular events among MPS and MSS group. Fatality outcomes in both groups were not exceeded 3%. No MI and re-PCI survival was 62 (92.5%) patients in MPS group and 67 (97.1%) in MSS group p>0.05). In general study population (n=136) MACE, re-MI, death and stent thrombosis obtained in 5.1%, 5.1%, 2.9% and 4.4% of patients, respectively. Conclusions: The use of similar latest generation DES and preventive approach (MPS and MSS with 10.1±5.1 days between procedures) used in index hospitalization period made it possible to obtain satisfactory results of revascularization compared to most similar randomized trials.