title: Clinical outcomes with the STENTYS self-apposing coronary stent in patients presenting with ST-segment elevation myocardial infarction: two-year insights from the APPOSITION III (A Post-Market registry to assess the STENTYS self-exPanding COronary Stent In AcuTe MyocardIal InfarctiON) registry.
abstract: OBJECTIVE
  The APPOSITION III registry evaluated the feasibility and performance of the STENTYS self-apposing stent in an ST-segment elevation myocardial infarction (STEMI) population. This novel self-apposing stent device lowers stent strut malapposition rates and therefore carries the potential to prevent stent undersizing during primary percutaneous coronary intervention (PCI) in STEMI patients. To date, no long-term data are available using this device in the setting of STEMI. We aimed to evaluate the long-term clinical outcomes of the APPOSITION III registry.
  
  
  RESULTS
  This was an international, prospective, multicentre post-marketing registry. The study population consisted of 965 STEMI patients. The primary endpoint, major adverse cardiac events (MACE), was defined as the composite of cardiac death, recurrent target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularisation (CD-TLR). At two years, MACE occurred in 11.2%, cardiac death occurred in 2.3%, TV-MI occurred in 2.3% and CD-TLR in 9.2% of patients. The two-year definite stent thrombosis (ST) rate was 3.3%. Incremental event rates between one- and two-year follow-up were 1.0% for TV-MI, 1.8% for CD-TLR, and 0.5% for definite ST. Post-dilation resulted in significantly reduced CD-TLR and ST rates at 30-day landmark analyses. Results were equivalent between the BMS and PES STENTYS subgroups.
  
  
  CONCLUSIONS
  This registry revealed low rates of adverse events at two-year follow-up, with an incremental ST rate as low as 0.5% in the second year, demonstrating that the self-apposing technique is feasible in STEMI patients on long-term follow-up while using post-dilatation.
authors.affiliation: Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Huangling
authors.initials: H
authors.lastname: Lu
authors.forename: Maik J
authors.initials: MJ
authors.lastname: Grundeken
authors.forename: Nicola S
authors.initials: NS
authors.lastname: Vos
authors.forename: Alexander J J
authors.initials: AJJ
authors.lastname: IJsselmuiden
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Rainer
authors.initials: R
authors.lastname: Wessely
authors.forename: Thomas
authors.initials: T
authors.lastname: Dengler
authors.forename: Alessio
authors.initials: A
authors.lastname: La Manna
authors.forename: Johanne
authors.initials: J
authors.lastname: Silvain
authors.forename: Gilles
authors.initials: G
authors.lastname: Montalescot
authors.forename: René
authors.initials: R
authors.lastname: Spaargaren
authors.forename: Jan G P
authors.initials: JGP
authors.lastname: Tijssen
authors.forename: Giovanni
authors.initials: G
authors.lastname: Amoroso
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D000072657:ST Elevation Myocardial Infarction / Q000601:surgery*; D016896:Treatment Outcome