Coronary disease & ACSRandomised controlled trial
Rapid Inflation-Deflation vs Pressure-Optimized Stenting During Primary Percutaneous Coronary Intervention (PCI)
- Randomised controlled trial
- multicentre
- blinded endpoint assessment
- 1:1 allocation
Authors' conclusion
Among patients with STEMI undergoing primary PCI, pressure-optimized stent inflation resulted in significantly higher rates of successful reperfusion than conventional stenting and reduced need for post dilation. A trend toward fewer 30-day major adverse cardiovascular events was observed.
Study context
- Population
- Patients undergoing primary PCI for STEMI
- Participants
- 607 patients
- Comparison
- Pressure optimization protocol (POP) vs Conventional
- POPn = 307
- Conventionaln = 300reference
- Primary endpoint
- Hierarchical reperfusion success (unmatched win ratio): ST-segment resolution ≥70% at 90 minutes, final TIMI grade 3, absence of slow-flow/no-reflow
Primary result
As reported in the abstract
Hierarchical reperfusion success (unmatched win ratio)
Win ratio
1.42
95% CI 1.11–1.79
P = 0.004
POP vs Conventional
win ratio 1.42 (95% CI 1.11–1.79); P = 0.004
- Net win difference
- +12.64% (95% CI 3.69-20.98)
Further findings
Hierarchical components: net win difference
- ST-segment resolution ≥70%
- +5.70% (95% CI −1.89 to 12.56)
- Final TIMI grade 3 flow
- +5.95% (95% CI 1.80-10.00)
Postdilation
- Postdilation less frequent with POP: 213 of 326 stents vs 294 of 323 (P < 0.001)
- 65.3% vs 91.0%
Safety
MACE (death, MI, stent thrombosis or stroke) · median follow-up 30 days (IQR: 29-32)
- Events, POP vs conventional
- 6 of 307 vs 12 of 300
- Kaplan-Meier event rates, POP vs conventional
- 2.0% vs 4.1% (95% CI 0.4-3.5 and 1.8-6.3)
- HR
- 0.49 (95% CI 0.18-1.31; P = 0.15)
Original publication
Rapid Inflation-Deflation vs Pressure-Optimized Stenting During Primary PCI. JACC Cardiovasc Interv. Published 24 August 2026. doi:10.1016/j.jcin.2026.06.024
Summarised from the published abstract; every number is checked against it