Post-dilatation with an NC balloon in STEMI patients undergoing primary PCI reduced in-hospital mortality to 4% vs 10.7% and cardiac arrest to 3.4% vs 9.2%.
Does post-dilatation with a noncompliant balloon reduce complications and mortality in STEMI patients undergoing primary PCI?
In a large retrospective cohort of STEMI patients undergoing primary PCI, post-dilatation with a noncompliant balloon was associated with significantly lower rates of immediate complications and in-hospital mortality.
Absolute Event Rate: 0% vs 0%
Abstract Introduction/Background Post-dilatation with a noncompliant (NC) balloon is generally associated with better expansion and apposition of stent struts, leading to improved immediate angiographic results and clinical outcomes. However, some studies have raised uncertainty about its utility, suggesting a potential aggravation of microvascular obstruction and vessel wall injury. Purpose Therefore, this study aimed to investigate the impact of post-dilatation on the incidence of complications in STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods In this retrospective descriptive study, we included consecutive adult STEMI patients (age ≥18 years) who underwent primary PCI between October 2022 and December 2024. Patients were categorized into two groups based on post-dilatation status after stent deployment. The post-dilatation and non-post-dilatation groups were compared for complications and immediate outcomes, including mortality, cardiac arrest, cardiogenic shock, heart failure, stroke, and stent thrombosis. Results The study sample consisted of 12,608 STEMI patients who underwent primary PCI, of whom 10,081 (80%) were male. The mean age was 55.8 ± 10.8 years. Post-dilatation with an NC balloon was documented in 7,935 (62.9%) patients. We observed that the non-post-dilatation group had a higher incidence of cardiac arrest (9.2% 428/4,673 vs. 3.4% 269/7,935; p0.001), cardiogenic shock (3.6% 170/4,673 vs. 1.6% 130/7,935; p0.001), heart failure (2% 94/4,673 vs. 0.8% 64/7,935; p0.001), and in-hospital mortality (10.7% 498/4,673 vs. 4% 319/7,935; p0.001). However, the rates of myocardial infarction (0.3% 16/4,673 vs. 0.3% 20/7,935; p=0.359), stroke (0.04% 2/4,673 vs. 0.04% 3/7,935; p0.999), cardiac tamponade (0.04% 2/4,673 vs. 0.03% 2/7,935; p=0.63), and stent thrombosis (0.5% 22/4,673 vs. 0.7% 54/7,935; p=0.142) did not significantly differ between the groups. Conclusion(s) Post-dilatation with an NC balloon after stent deployment in patients undergoing primary PCI is associated with improved clinical outcomes and lower rates of post-procedure complications.
Bhatti et al. (Sat,) reported a other. Post-dilatation with an NC balloon in STEMI patients undergoing primary PCI reduced in-hospital mortality to 4% vs 10.7% and cardiac arrest to 3.4% vs 9.2%.