One-Year Clinical Outcomes of Patients Presenting With ST-Segment Elevation Myocardial Infarction Caused by Bifurcation Culprit Lesions Treated With the Stentys Self-Apposing Coronary Stent: Results From the APPOSITION III Study

Autor: Grundeken, M. J., Lu, H., Vos, N., Ijsselmuiden, A., Geuns, R. -J, Wessely, R., Dengler, T., La Manna, A., Silvain, J., Montalescot, G., Spaargaren, R., Tijssen, J. G. P., Winter, R. J., Joanna Wykrzykowska, Amoroso, G., Koch, K. T.
Přispěvatelé: Cardiology, Other departments, ACS - Atherosclerosis & ischemic syndromes, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Journal of invasive cardiology, 29(8), 253-258. HMP Communications
Journal of Invasive Cardiology, 29(8), 253-258. HMP Communications
Scopus-Elsevier
Journal of Invasive Cardiology, 29, 8, pp. 253-258
Journal of Invasive Cardiology, 29, 253-258
ISSN: 1042-3931
Popis: Item does not contain fulltext OBJECTIVE: To investigate outcomes in patients with ST-segment elevation myocardial infarction (STEMI) after treatment with the Stentys self-apposing stent (Stentys SAS; Stentys S.A.) for bifurcation culprit lesions. BACKGROUND: The nitinol, self-expanding Stentys was initially developed as a dedicated bifurcation stent. The stent facilitates a provisional strategy by accommodating its diameter to both the proximal and distal reference diameters and offering an opportunity to "disconnect" the interconnectors, opening the stent toward the side branch. METHODS: The APPOSITION (a post-market registry to assess the Stentys self-expanding coronary stent in acute myocardial infarction) III study was a prospective, multicenter, international, observational study including STEMI patients undergoing primary percutaneous coronary intervention (PCI) with the Stentys SAS. Clinical endpoints were evaluated and stratified by bifurcation vs non-bifurcation culprit lesions. RESULTS: From 965 patients included, a total of 123 (13%) were documented as having a bifurcation lesion. Target-vessel revascularization (TVR) rates were higher in the bifurcation subgroup (16.4% vs 10.0%; P=.04). Although not statistically significant, other endpoints were numerically higher in the bifurcation subgroup: major adverse cardiac events (MACE; 12.7% vs 8.8%), myocardial infarction (MI; 3.4% vs 1.8%), and definite/probable stent thrombosis (ST; 5.8% vs 3.1%). However, when postdilation was performed, clinical endpoints were similar between bifurcation and non-bifurcation lesions: MACE (8.7% vs 8.4%), MI (1.2% vs 0.7%), and definite/probable ST (3.7% vs 2.4%). CONCLUSIONS: The use of the Stentys SAS was safe and feasible for the treatment of bifurcation lesions in the setting of primary PCI for STEMI treatment with acceptable 1-year cardiovascular event rates, which improved when postdilation was performed.
Databáze: OpenAIRE
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