The goal of primary PCI is to restore anterograde myocardial flow. Stenting a largely thrombotic lesion may determine distal embolisation of thrombotic material therefore deteriorating myocardial perfusion.
In the setting of largely thrombotic lesions such as those treated in the context of primary PCI, stenting often results in distal micro and macro-embolisation which hampers coronary flow and microvascular recovery. Interestingly in some of these studies comparing BMS versus balloon angioplasty an early hazard associated to the use of stent has been reported. Thus, investigators hypothesize in this protocol that refraining from stenting during the acute phase of ST segment myocardial infarction is safe and associated to improved myocardial recovery as compared to acute stenting.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Primary coronary stenting
Coronary stenting 3 to 7 days after having reopened the vessel in the acute phase
U.O. Cardiologia
Ferrara, Emilia-Romagna, Italy
RECRUITINGMyocardial blush grade (MBG) equal or greater than 2
The MBG will be estimated visually by 2 experienced observers, as previously described.
Time frame: post-procedure
ST segment elevation resolution
Cumulative ST segment elevation in all leads will be quantified before and after the procedure and expressed as percentage
Time frame: 30 minutes after the procedure
ST segment elevation Resolution
Time frame: 90 minutes after the procedure
infarct size
Infarct size will be quantified by MRI
Time frame: 5 days
Infarct size
Infarct size will be quantified by MRI
Time frame: 6 months
microvascular obstruction
microvascular obstruction will be quantified by MRI
Time frame: 5 days
microvascular obstruction
microvascular obstruction will be quantified by MRI
Time frame: 6 months
Mortality
overall and cardiac mortality will be assessed up to 6 months
Time frame: 6 months
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