Stent Implantation With or Without Pre-Dilation in Non-ST-Segment-Elevation Acute Coronary Syndrome Patients

ABSTRACT Background The benefits of direct stenting in non-ST-segmentelevation acute coronary syndromes (NSTE ACS) are not clearly established. We compared stenting with or without pre-dilation (direct stenting) of the target lesion in this population. Methods Single center, retrospective registry including NSTE ACS patients treated from 2009 to 2010. Stenting for bifurcations, saphenous vein grafts, and in-stent restenosis were excluded. The primary endpoint was the comparison of in-hospital and late major adverse cardiac events (MACE). Results Of a total of 182 patients, 42.3% were treated by direct stenting. Mean age was 61.1 ± 11.0 years, 67% were male and 33.5% were diabetics. Patients in the pre-dilation group had more type C lesions (37.1% vs. 18.2%; P = 0.01), smaller reference vessel diameter (2.3 [2.0-2.7] mm vs. 2.7 [2.2-3.1] mm; P = 0.01) and smaller preintervention minimal luminal diameter (0.5 [0.1-0.7] mm vs.0.6 [0.4-1.0] mm; P   0.99). Conclusions In this series of NSTE ACS patients, direct stenting was not associated with better angiographic or clinical outcomes. However, lesion complexity remains a determinant factor in the choice of the pre-dilation strategy in daily practice.