TOPLINE:

Around 1 in 5 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) experienced target lesion failure (TLF) within 10 years, with older age and other comorbidities identified as risk factors.

METHODOLOGY:

• Researchers analysed data from the DANAMI-3 trial to evaluate the occurrence and predictors of TLF in 2217 patients with STEMI treated with primary PCI (median age range, 61-66 years; 74%-78% men) at four Danish centres between 2011 and 2014.
• TLF was defined as a composite of cardiovascular death, TL MI, or TL revascularisation and was evaluated over a median follow-up duration of 10.7 years.
• Secondary outcomes were a patient-oriented composite of major adverse cardiac events.
• A high-risk group was defined as patients older than 70 years plus having at least one of the following: hypertension, prior acute MI, or Killip class II-IV; 53.9% of patients were at high risk.

TAKEAWAY:

• At 10 years, 20% of patients experienced TLF, with 5.6% experiencing it within the first year of PCI followed by a steady annual rate of 1.6%.
• Older age, hypertension, prior acute MI, and Killip class II-IV independently predicted an increased risk for TLF (P < .01 for all); however, PCI with second-generation drug-eluting stents was linked to a reduced risk (P = .005).
• Patients in the high-risk group had more than twice the risk of having TLF as those in the low-risk group (P < .001).
• TLF accounted for 46% of total patient-oriented major adverse cardiac events.

IN PRACTICE:

"[The study] findings show that there is a growing need to focus on improving long-term outcomes by preventing TLF," the researchers wrote.

SOURCE:

This study was led by Burcu Tas Özbek, Rigshospitalet Hjertecentret, Copenhagen, Denmark. It was published online on November 13, 2025, in Open Heart.

LIMITATIONS:

STEMI care had evolved over the decade. After 5 years, follow-up events were collected retrospectively from medical records and national registries. Events beyond 5 years were not adjudicated by an independent clinical events committee.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.