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 STelevation 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.