title: The impact of multiple stent implantation in the infarct-related artery on one-year clinical outcomes of patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Data from the Polish NRDES Registry.
abstract: OBJECTIVE
  We sought to evaluate the impact of multiple stent implantation in the infarct-related artery (IRA) on one-year clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  RESULTS
  Data on 1741 consecutive patients with STEMI, who underwent immediate PCI with implantation of ≥ 1 stent, enrolled the National Registry of Drug Eluting Stents (NRDES) were assessed. Patients were stratified based on the number of implanted stents in IRA: 1 vs. ≥ 2 stents. At the discretion of operators, ≥ 2 stents in IRA were implanted in 247 (14.2%) patients. The remaining 1494 patients were treated with a single stent. Patients treated with multiple stents were less likely to achieve Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow after primary PCI. Overall mortality at one year was 8.3% in the single stent group and 10.3% in the ≥ 2 stents group (p = 0.37; adjusted for propensity score p = 0.13). After propensity score matching, patients treated with ≥ 2 stents were at higher risk of definite or probable stent thrombosis and urgent revascularisation at one year.
  
  
  CONCLUSIONS
  In patients with STEMI undergoing primary PCI, a need for implantation of ≥ 2 stents in IRA carries an increased risk of stent thrombosis and urgent revascularisation at one year.
authors.affiliation: 2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland. adziewierz@gmail.com.
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Siudak
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zasada
authors.forename: Jacek
authors.initials: J
authors.lastname: Legutko
authors.forename: Anna
authors.initials: A
authors.lastname: Żabówka
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Partyka
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D000328:Adult; D000368:Aged; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011044:Poland; D012042:Registries; D000072657:ST Elevation Myocardial Infarction / Q000601:surgery*; D016896:Treatment Outcome
keywords: ST elevation myocardial infarction; bare-metal stent; drug-eluting stent; primary angioplasty