Reduced Stent Strategy Versus Conventional Percutaneous Coronary Revascularization in Patients Presenting With STEMI

Reduced Stent Strategy Versus Conventional Percutaneous Coronary Revascularization in Patients Presenting With St-segment Elevation Myocardial Infarction (Copernican)

The objective is to compare a reduced stent strategy based on drug-coated balloon (DCB) percutaneous coronary intervention (PCI) with conventional drug-eluting stent (DES) coronary revascularization in patients presenting with ST-segment myocardial infarction (STEMI).

Randomization will be performed after successful culprit-lesion guidewire crossing and flow restoration. Random allocation in a 1:1 fashion to one of the following strategies:

• Study group: reduced stent PCI strategy (DCB-based)
• Control group: conventional PCI strategy (DES-based).

Inclusion Criteria:

- Patients presenting with STEMI and indication to undergo pPCI.

Exclusion Criteria:

• Life expectancy <1 year due 1 to non-cardiac disease.
• Inability to provide informed consent.
• Cardiogenic shock.
• Left ventricular ejection fraction <15%.
• Left main disease.
• Stent thrombosis
• Patients with prior bypass graft lesions requiring PCI (culprit or non culprit lesions).
• Patients with chronic total occlusions.
• Untreatable coronary disease.
• Non-identified culprit lesion.
• Known allergy to aspirin, ticagrelor, prasugrel, clopidogrel, paclitaxel or sirolimus.