Background
The independent advantages of percutaneous coronary intervention (PCI) with direct stenting (DS) when compared against balloon pre-dilatation (PD) are not entirely clear. Previous studies suggest a decrease in the incidence of periprocedural myocardial injury (PPMI), no-reflow phenomenon, and stent edge restenosis with DS, but baseline patient differences and selection bias could account for these results. This study aimed to compare these two competing strategies during elective PCI and determine outcomes after meticulous adjustment for baseline differences.
Method
Patients undergoing elective PCI from 01/2000 to 12/2010 were considered. The rate of PPMI was defined as a post procedure creatine kinase MB elevation of 3× the upper limit of normal, target-lesion revascularization (TLR) was clinically driven and a composite 1-year outcome (MACE) consisting of all-cause mortality, Q-wave-myocardial infarction, or TLR was tracked and compared among patients undergoing either stenting technique. Propensity-score matching from a non-parsimonious logistic regression model for treatment with DS vs. PD was constructed utilizing 27 demographic, clinical, angiographic, and procedural variables that balanced the characteristics of the two groups. A cohort of 444 patients treated by DS was matched one-to-one to 444 treated by PD using the nearest available pair matching method.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
