Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents

Roman S. Tarasov; Vladimir I. Ganyukov; Alexey V. Protopopov; Olga L. Barbarash; Leonid S. Barbarash

doi:doi:10.11648/j.cmr.20140305.12

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Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents

Roman S. Tarasov, Vladimir I. Ganyukov, Alexey V. Protopopov, Olga L. Barbarash, Leonid S. Barbarash

Published in Clinical Medicine Research (Volume 3, Issue 5)

Received: 6 August 2014 Accepted: 23 August 2014 Published: 30 August 2014

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Abstract

Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.

Published in	Clinical Medicine Research (Volume 3, Issue 5)
DOI	10.11648/j.cmr.20140305.12
Page(s)	125-129
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

ST-Elevation Myocardial Infarction, Primary Percutaneous Coronary Intervention, Multivessel Coronary Artery Disease, Second Generation Drug-Eluting Stents

References

[1]	Sorjja P, Gersh BJ, Cox DA et al. Impact of multivessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Eur. Heart J. 2007; 28:1709-16.
[2]	Jang HL, Hun SP, Shung ChCh et al. Wee Hyun Park and Korea Acute Myocardial Infarction Registry Investigators. Predictors of six-month major adverse cardiac events in 30-day survivors after acute myocardial infarction (from the Korea Acute Myocardial Infarction Registry). Am. J. Cardiol. 2009;104:182–89.
[3]	Rasoul S, Ottervanger JP, de Boer MJ. et al. Predictors of 30-day and 1-year mortality after primary percutaneous coronary intervention for ST-elevation myocardial infarction. Coron. Artery Dis. 2009; 20: 415–21.
[4]	Webb JG, Lowe AM, Sanborn TA, et al. Percutaneous coronary intervention for cardiogenic shock in the SHOCK trial. J Am Coll Cardiol 2003;42:1380-86.
[5]	Smith SC, Jr, Feldman TE, Hirshfeld JW Jr, et al. ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Interventiondsummary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). Circulation 2006;113:156-75.
[6]	Ijsselmuiden AJ, Ezechiels J, Westendorp IC, et al. Complete versus culprit vessel percutaneous coronary intervention in multivessel disease: a randomized comparison. Am Heart J 2004;148:467-74.
[7]	Politi L, Sgura F, Rossi R, et al. A randomised trial of target-vessel versus multi-vessel revascularisation in ST-elevation myocardial infarction: major adverse cardiac events during long-term follow-up. Heart 2010; 96:662-67.
[8]	Fox K, Garcia MA, Ardissino D, et al. Guidelines on the management of stable angina pectoris: executive summary. The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006;27:1341-81.
[9]	Gabriel S, Stefan K, James, DA, et al. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). European Heart Journal 2012. doi:10.1093/eurheartj/ehs215.
[10]	Roe MT, Cura FA, Joski PS, et al. Initial experience with multivessel percutaneous coronary intervention during mechanical reperfusion for acute myocardial infarction. Am J Cardiol 2001; 88:170-173.
[11]	Corpus RA, House JA, Marso SP, et al. Multivessel percutaneous coronary intervention in patients with multivessel disease and acute myocardial infarction. Am Heart J 2004; 148:493-500.
[12]	Widimsky P, Holmes Jr David R. How to treat patients with ST-elevation acute myocardial infarction and multi-vessel disease? European Heart Journal Advance Access published November 30, 2010. European Heart Journal doi:10.1093/eurheartj/ehq410.
[13]	Politi L, Sgura F, Rossi R, et al. A randomised trial of target-vessel versus multi-vessel revascularization in ST-elevation myocardial infarction: major adverse cardiac events during long-term follow-up. Heart 2010; 96:662–667.
[14]	Varani E, Balducelli M, Aquilina M, et al. Single or multivessel percutaneous coronary intervention in ST-elevation myocardial infarction patients. Catheter Cardiovasc Interv 2008;72:927–933.
[15]	Roe MT, Cura FA, Joski PS, et al. Initial experience with multivessel percutaneous coronary intervention during mechanical reperfusion for acute myocardial infarction. Am J Cardiol 2001;88:170–173.
[16]	Hannan EL, Samadashvili Z, Walford G, et al. Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease. JACC Cardiovasc Interv 2010; 3:22–31.
[17]	Goldstein JA, Demetriou D, Grines CL, et al. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med 2000;343:915-22.
[18]	Cutlip D.E., Windecker S., Mehran R., et al. Clinical endpoints in coronary stent trials: a case for standardized definitions. Circulation 2007; 115:2344-2351.

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APA Style

Roman S. Tarasov, Vladimir I. Ganyukov, Alexey V. Protopopov, Olga L. Barbarash, Leonid S. Barbarash. (2014). Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents. Clinical Medicine Research, 3(5), 125-129. https://doi.org/10.11648/j.cmr.20140305.12

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ACS Style

Roman S. Tarasov; Vladimir I. Ganyukov; Alexey V. Protopopov; Olga L. Barbarash; Leonid S. Barbarash. Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents. Clin. Med. Res. 2014, 3(5), 125-129. doi: 10.11648/j.cmr.20140305.12

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AMA Style

Roman S. Tarasov, Vladimir I. Ganyukov, Alexey V. Protopopov, Olga L. Barbarash, Leonid S. Barbarash. Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents. Clin Med Res. 2014;3(5):125-129. doi: 10.11648/j.cmr.20140305.12

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@article{10.11648/j.cmr.20140305.12,
  author = {Roman S. Tarasov and Vladimir I. Ganyukov and Alexey V. Protopopov and Olga L. Barbarash and Leonid S. Barbarash},
  title = {Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents},
  journal = {Clinical Medicine Research},
  volume = {3},
  number = {5},
  pages = {125-129},
  doi = {10.11648/j.cmr.20140305.12},
  url = {https://doi.org/10.11648/j.cmr.20140305.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140305.12},
  abstract = {Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.},
 year = {2014}
}

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TY  - JOUR
T1  - Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
AU  - Roman S. Tarasov
AU  - Vladimir I. Ganyukov
AU  - Alexey V. Protopopov
AU  - Olga L. Barbarash
AU  - Leonid S. Barbarash
Y1  - 2014/08/30
PY  - 2014
N1  - https://doi.org/10.11648/j.cmr.20140305.12
DO  - 10.11648/j.cmr.20140305.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 125
EP  - 129
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20140305.12
AB  - Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.
VL  - 3
IS  - 5
ER  -

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Author Information

Roman S. Tarasov

Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Vladimir I. Ganyukov

Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Alexey V. Protopopov

Department of interventional cardiology, Krasnoyarsk Regional Hospital, Krasnoyarsk, Russia
Olga L. Barbarash

Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia
Leonid S. Barbarash

Laboratory of interventional cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Russian Academy of Medical Science, Kemerovo, Russia

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APA Style

Roman S. Tarasov, Vladimir I. Ganyukov, Alexey V. Protopopov, Olga L. Barbarash, Leonid S. Barbarash. (2014). Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents. Clinical Medicine Research, 3(5), 125-129. https://doi.org/10.11648/j.cmr.20140305.12

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ACS Style

Roman S. Tarasov; Vladimir I. Ganyukov; Alexey V. Protopopov; Olga L. Barbarash; Leonid S. Barbarash. Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents. Clin. Med. Res. 2014, 3(5), 125-129. doi: 10.11648/j.cmr.20140305.12

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AMA Style

Roman S. Tarasov, Vladimir I. Ganyukov, Alexey V. Protopopov, Olga L. Barbarash, Leonid S. Barbarash. Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents. Clin Med Res. 2014;3(5):125-129. doi: 10.11648/j.cmr.20140305.12

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@article{10.11648/j.cmr.20140305.12,
  author = {Roman S. Tarasov and Vladimir I. Ganyukov and Alexey V. Protopopov and Olga L. Barbarash and Leonid S. Barbarash},
  title = {Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents},
  journal = {Clinical Medicine Research},
  volume = {3},
  number = {5},
  pages = {125-129},
  doi = {10.11648/j.cmr.20140305.12},
  url = {https://doi.org/10.11648/j.cmr.20140305.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140305.12},
  abstract = {Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.},
 year = {2014}
}

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TY  - JOUR
T1  - Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
AU  - Roman S. Tarasov
AU  - Vladimir I. Ganyukov
AU  - Alexey V. Protopopov
AU  - Olga L. Barbarash
AU  - Leonid S. Barbarash
Y1  - 2014/08/30
PY  - 2014
N1  - https://doi.org/10.11648/j.cmr.20140305.12
DO  - 10.11648/j.cmr.20140305.12
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 125
EP  - 129
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20140305.12
AB  - Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.
VL  - 3
IS  - 5
ER  -

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