Tetra Randomized European Direct Stenting Study - TRENDS


A randomized trial to compare stending with or without predilation.

Study Design

Patients Enrolled: 1,000
Mean Follow Up: 30 days


Patients with acute myocardial infarction within the previous 24 hours.

Drug/Procedures Used:

1,000 patients with symptomatic angina and de novo single lesions or restenotic lesions in native coronary arteries were randomly assigned to stenting with or without predilation. Patients with acute myocardial infarction (within the previous 24 hours) were excluded from enrollment. More than 90% of the patients in each group had single vessel disease. The patients were randomized to a predilatation or direct stenting strategy and were followed for 30-day outcomes.

Principal Findings:

Major adverse coronary events (death, MI, coronary artery bypass grafting or repeat percutaneous intervention) occurred at a rate of 4.2% with the predilatation strategy and 3.4% with the direct stenting strategy. Failure to deploy the stent was uncommon with direct stenting, occurring in only 5.8% of patients.


Among patients with angina who are not undergoing primary stenting for acute MI, direct stenting without predilation was not associated with an increase in major adverse coronary events at 30 days.


Dawkins KD, Chevalier B, Suttorp MJ, et al. Effectiveness of "direct" stenting without balloon predilatation (from the Multilink Tetra Randomised European Direct Stent Study [TRENDS]). Am J Cardiol. 2006 Feb 1;97(3):316-21.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention

Keywords: Myocardial Infarction, Coronary Artery Bypass, Stents

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