Real-World Assessment of an Ultrathin Strut, Sirolimus-Eluting Stent in Patients with ST-Elevation Myocardial Infarction Submitted to Primary Percutaneous Coronary Intervention (INSTEMI Registry)

Background: The current gold standard of coronary drug-eluting stents (DES) consists of metal alloys with thinner struts and bioresorbable polymers.Objectives: Our aim was to compare an ultrathin strut, sirolimus-eluting stent (Inspiron (R)) with other third-generation DES platforms in patients with ST-elevation myocardial infarction (STEMI) submitted to primary percutaneous coronary intervention (PCI).Methods: We analyzed data from a STEMI multicenter registry from reference centers in the South Region of Brazil. All patients were submitted to primary PCI, either with Inspiron (R) or other second-or third-generation DES. Propensity score matching (PSM) was computed to generate similar groups (Inspiron (R) versus other stents) in relation to clinical and procedural characteristics. All hypothesis tests had a two-sided significance level of 0.05.Results: From January 2017 to January 2021, 1711 patients underwent primary PCI, and 1417 patients met our entry criteria (709 patients in the Inspiron (R) group and 708 patients in the other second-or third-generation DES group). After PSM, the study sample was comprised of 706 patients (353 patients in the Inspiron (R) group and 353 patients in the other the other second-or third-generation DES group). The rates of target vessel revascularization (OR 0.52, CI 0.21 - 1.34, p = 0.173), stent thrombosis (OR 1.00, CI 0.29 - 3.48, p = 1.000), mortality (HR 0.724, CI 0.41 - 1.27, p = 0.257), and major cardiovascular outcomes (OR 1.170, CI 0.77 - 1.77, p = 0.526) were similar between groups after a median follow-up of 17 months.Conclusion: Our findings show that Inspiron (R) was effective and safe when compared to other second-or third-generation DES in a contemporary cohort of real-world STEMI patients submitted to primary PCI.

Automated summary

This study compared the effectiveness of an ultrathin strut, sirolimus-eluting stent (Inspiron) with other third-generation drug-eluting stents (DES) in ST-elevation myocardial infarction (STEMI) patients. The results showed no significant differences in the rates of target vessel revascularization, stent thrombosis, mortality, and major cardiovascular outcomes between the two groups after a median follow-up of 17 months. Therefore, this study confirmed the safety and effectiveness of Inspiron in real-world clinical practice.