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Outcomes of patients with non-ST elevation acute coronary syndrome and a negative residual stenosis after coronary stenting

BACKGROUND: Negative residual stenosis (RS) after coronary stenting is associated with worse antegrade flow and increased mortality in patients with acute myocardial infarction. Its influence on outcomes of patients with non-ST elevation acute coronary syndromes is unknown. METHODS: Patients with acute coronary syndrome with non-ST elevation treated with coronary stenting were included and RS and coronary flow were assessed immediately after the procedure. Patients with RS < 0% were compared to a control group with RS 0-30% for the occurrence of one-year MACE. RESULTS: Baseline clinical characteristics were similar in both groups. Mean residual stenosis was -10.3 ± 6.4% in the < 0% RS group (n = 94) and 2.1 ± 5.2% in controls (n = 298) (P < 0.001). Patients with RS < 0% had smaller vessels (P < 0.001) and were treated with a higher aggressiveness score (P < 0.001), which were independent predictors of the occurrence of negative RS. Clinical procedural success rates (100% vs. 98.7%) and coronary TIMI 3 flow rates (100% vs. 99.3%) were similar in both groups. In-hospital MACE (0% vs. 0.6%) and subacute thrombosis rates (1.1% vs. 0.3%) were not statistically different. One-year target vessel revascularization rates (8.9% vs. 7.9%) and one-year MACE rates (10% vs. 10%) were also similar. CONCLUSIONS: Negative residual stenosis after coronary stenting in patients with non-ST elevation acute coronary syndrome was associated with smaller vessels and more aggressive implantation strategies, but not with worse coronary flow or higher MACE rates.

Angina, unstable; Stents; Coronary disease


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