Journal
EUROINTERVENTION
Volume 8, Issue 10, Pages 1207-1216Publisher
EUROPA EDITION
DOI: 10.4244/EIJV8I10A185
Keywords
delayed PCI; deferred PCI; immediate PCI; STEMI
Categories
Funding
- les Fonds la recherche en sante du Quebec (FRSQ)
- la Fondation de l'Institut de Cardiologie de Montreal
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Aims: To conduct a meta-analysis of studies comparing immediate versus delayed stenting in populations where primary percutaneous coronary intervention (PCI) or early invasive revascularisation was the initial mode of reperfusion. Methods and results: We identified five non-randomised studies and one randomised trial for a total of 590 patients in studies comparing immediate to delayed stenting in populations where primary PCI or early invasive revascularisation was the initial mode of reperfusion. In non-randomised studies, delayed stenting was associated with a reduction of procedure-related angiographic events (OR=0.13, 95% credible interval [CrI]: 0.03-0.36). No differences were observed in the rates of major bleeding (OR=0.81, 95% CrI: 0.01-13.42) and major adverse cardiac events (OR=0.40, 95% CrI: 0.09-1.91), between delayed and immediate stenting. In one randomised trial, delayed stenting was associated with a reduction in myocardial infarction during hospitalisation (39% vs. 60%; relative risk [RR]=0.55, 95% confidence interval [CI]: 0.39-0.80). None of the patients assigned to delayed stenting experienced a major adverse cardiac event in the interval between the initial angiogram and the stenting. Conclusions: Delayed stent implantation is associated with better angiographic outcomes. Randomised trials are required to assess whether delayed stenting translates into better long-term cardiac outcomes.
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