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Document Type

Original Article

Abstract

Background: No clear recommendations as regard deferred stenting in ST-segment elevation myocardial infarction (STEMI) patients with big thrombus load.

Aim of the study: our study might answer the question that deferred stenting might reduce no-reflow and in-hospital major adverse cardiac events (MACE) compared to immediate stenting in primary percutaneous coronary intervention (PCI) for STEMI patients with high thrombus burden.

Patients and Methods: a prospective double blinded control non-randomized study which included fifty Patients presented by STEMI with high thrombus load and undergoing primary PCI, 25 patients (group number 1) managed with deferred stenting, and 25 patients (group number 2) managed with immediate stenting. All patients follow up for MACE during hospital stay and follow up echocardiography was done on admission and after 6months. Result: Stenting was avoided in 36% of patients in group number 1; p=0.001. As regard, Left Ventricular Ejection Fraction (LVEF), deferred stenting showed improvement of EF on 6 months follow up when compared to the direct conventional stenting (47.28 ± 6.43 vs 41.33 ± 9.10); p=0.011. Deferred stenting did not show any decrease in no-reflow or in hospital MACE when compared to direct conventional stenting.

Conclusion: Deferred stenting specific category of patients presenting with STEMI and big thrombus burden undergoing primary PCI, may improve LEVF, and avoid unneeded stenting with its potential complication when compared to conventional direct stenting, but it is not improving clinical outcome or decreasing incidence of no-reflow nor MACE during the hospital stay

Keywords

Deferred; Thrombus; STEMI; PCI

Subject Area

Cardiovascular

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