Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-008
Predilatation Before Stenting Versus Direct Stenting in Patients Presenting With St-Elevation Myocardial Infarction and Managed by Primary Percutaneous Coronary Intervention
By Walid Jomaa, Taha Lassoued, Hajer Farhat, Ikram Chamtouri, Ahmed Turki, Khaldoun Ben Hamda
Presenter
Walid Jomaa
Authors
Walid Jomaa1, Taha Lassoued1, Hajer Farhat1, Ikram Chamtouri1, Ahmed Turki1, Khaldoun Ben Hamda1
Affiliation
Fattouma Bourguiba University Hospital, Tunisia1
View Study Report
TCTAP A-008
ACS/AMI
Predilatation Before Stenting Versus Direct Stenting in Patients Presenting With St-Elevation Myocardial Infarction and Managed by Primary Percutaneous Coronary Intervention
Walid Jomaa1, Taha Lassoued1, Hajer Farhat1, Ikram Chamtouri1, Ahmed Turki1, Khaldoun Ben Hamda1
Fattouma Bourguiba University Hospital, Tunisia1
Background
In patients treated with primary percutaneous coronary intervention (pPCI) for ST elevation myocardial infarction (STEMI), whether to perform predilatation or direct stenting remain still debated. In the current study, we aimed at comparing the prognostic impact of predilatation versus direct stenting in patients undergoing pPCI.
Methods
In this single center retrospective study, all patients presenting with STEMI and managed with pPCI from 2011 to 2020 were enrolled. Study population was split into two groups: group 1,including patients treated with balloon predilatation before stenting and group 2, including those treated by direct stenting. Clinical outcomes were compared between the two groups.
Results
A total of 325 patients were included, with 145 (44.6%) patients in group 1 and 180 (55.4%) in group 2. Mean age was 59.9 ± 11.3 years and 272 (83.7%) patients were male. Prevalence of diabetes, hypertension and tobacco smoking was 32.6%, 28.9% and 54.8%, respectively. Hemodynamic instability at admission was significantly higher in group 1 compared to group2 (17.2% vs. 8.3%, p = 0.003). Initial TIMI 0 flow on angiography was significantly higher in group 1 (91.7% vs. 80%, p = 0.033). Coronary iatrogenic dissection occurred more frequently in group 1 (13.1% vs. 3.3%, p = 0.001). TIMI 3 flow at the end of pPCI was achieved more frequently in group 2 (82.7% vs. 91.1%, p = 0.024). No-reflow occurred more often in group 1 (14.4% vs. 6.1%, p = 0.012). Both in-hospital and 12-month mortality were significantly higher in group 1 (14.4% vs. 3.8%, 15.1% vs. 4.4%,respectively, p < 0.001 for both). In multivariable analysis, balloon predilatation was an independent predictor factor for iatrogenic dissection (odds ratio 3.35, 95% confidence interval 1.27 - 9.77, p = 0.015).
Conclusion
In this study, compared to direct stenting, predilatation was associated with a higher incidence of coronary iatrogenic dissection,angiographic procedural failure, no-reflow and higher in-hospital and 12-month mortality in univariate analysis. In multivariate analysis, balloon predilatation was independently predictive only for iatrogenic dissection.