The impact of multiple overlapping new generations drug-eluting stents on six-month clinical outcomes in patients with anterior STEMI treated with primary PCI

Background Implantation of multiple (≥ 2) overlapping stents has been associated with adverse outcomes after percutaneous coronary intervention (PCI). However, data regarding the impact of multiple new generations drug-eluting stents (DES) during primary PCI (PPCI) are limited. Objective To evaluate the impact of multiple overlapping stents implantation on the 6-months clinical outcomes of anterior STEMI patients undergoing PPCI with new generations DES. Methods We evaluated a total of 1078 consecutive anterior STEMI patients who underwent PPCI with deployment of new generations DES. The patients were divided according to the number of implanted stents into 2 groups; multiple-stents group having ≥2 overlapping stents (n =388) and single-stent group (n =690). We compared the rates of major adverse cardiovascular events (MACEs; composite of cardiac death, reinfarction, ischemia-driven target vessel revascularization (TVR), definite stent thrombosis (ST), and stroke) between the 2 study groups. Results There was a non-significant trend toward increased in-hospital mortality in the multiple-stents group [3.4% vs 1.7%; P=0.096]related to a significant higher rate of cardiogenic shock [9.5% vs 6.1%; P=0.037] and post-procedural suboptimal TIMI flow [26.3% vs 19.4%; P=0.009] as compared to the single-stent group. Yet, there were no significant differences between the 2 groups in the incidence of 6-month MACEs: [9% vs 7.1%; P=0.259], cardiac death: [4.6% vs 3%; P=0.173], reinfarction: [3.6% vs 3.2%; P=713], TVR: [4.4% vs 4.1%; P=0.799], and definite ST: [3.6% vs 2.8%; P=0.43], respectively. Conclusion The use of multiple new generations DES, if needed, is relatively safe and acceptable during PPCI for STEMI patients.