Outcome of Immediate versus Delayed Stenting in ST-segment Elevation Myocardial Infarction Patients with High Thrombus Burden

Document Type : Original Article

Authors

1 Cardiology departement , faculty of medicine, zagazig university

2 cardiology department-zagazig university

3 Cardiology department, Faculty of medicine, Zagazig university, Zagazig, Egypt

4 department of cariology - National heart institute -Giza work as aphysician

Abstract

The safety of deferred stenting as a technique in STEMI patients is questioned by guidelines. Objectives: To see how effective immediate stenting versus delayed stenting is at lowering angiographic outcomes (no/slow reflow, distal embolization, and improved myocardial blush grade MBG) in STEMI patients. One of the clinical outcome criteria utilized to assess the study (during the initial stay and 6 months after discharge) was the incidence of Major adverse cardiac events(MACE). Methods: 108 patients of STEMI with heavy thrombus burden divided equally into 2 groups: Group (1): 54 patients treated with immediate stenting and Group (2) 54 patients treated with deferred stenting. Procedural angiographic events were the primary endpoints, while in MACE and bleeding complication were the secondary endpoints. Results: Deferred stenting patients had a statistically significant decrease in slow flow and no reflow (P = 0.03). defer group showed a greater increase in myocardial blush grade (MBG) than immediate stenting group. (p value 0.04). Distal embolization showed no statistical difference (p value 0.1), and there was no significant variation between the two classes in terms of bleeding complications (p value 0.7). Also, there was no statistically improvement in the deferred stenting group (P value = 0.3) by comparing the Composite of MACEs between the two classes. Conclusion Deferred stenting was associated with improved immediate myocardial perfusion, less no/slow reflow, and distal embolization, but not with a decrease in MACEs at 6 months, so direct stenting is a standard treatment option for STEMI patients

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Zagazig University Medical Journal
Volume 30, Issue 2
March and April 2024
Pages 350-357

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