Safety and Efficacy of Drug-eluting Stents in Bifurcation Lesions in Patients with Acute Myocardial Infarction

Background and Objectives: Drug eluting stents (DES) had shown to significantly reduce the angiographic and clinical events in bifurcation lesions. There is insufficient data on such outcomes in patients with bifurcation lesions and acute myocardial infarction [AMI]. The aim of this study was to analyze the safety and efficacy of DES in bifurcation lesions in the setting of AMI.

Methods: We analyzed 616 consecutive patients who underwent PCI of bifurcation lesions with drug eluting stents, 206 of those patients presented with AMI and are covered herein.

Results: Patients` mean age was 63±12, 75 (36%) presented with ST-elevation MI, 131 (64%) with NSTEMI, DM was observed in 65 (32%), renal insufficiency in 19 (9%), MVD observed in 151 (73%). The LAD/Diagonal location was the target in 58% of the vessels. Single stent strategy was observed in 144 (70%) of cases, and 2-stents were utilized in 62 (30%). Cross-over from 1 to 2-stent strategy was needed in 12 patients (8.3%). Kissing balloon inflation was performed in 75% cases. The one-year rate of death was 5.8%, re-MI 4.9%, stent thrombosis (definite) 1.5%, CABG 3%, TVR 5.3%, and MACE was 13%. Two stent strategy in bifurcation lesion was not associated with worse clinical outcomes.

Conclusions: Despite the complex clinical and angiographic milieu, the use of DES in AMI patients with bifurcation lesions showed favorable clinical outcomes.