{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:30:52Z","timestamp":1786739452145,"version":"build-2736575974"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"Abstract<\/jats:title>\n \n Objectives:<\/jats:title>\n The optimal timing of stent implantation in ST-segment elevation myocardial infarction (STEMI) with high thrombus burden remains uncertain. Immediate stenting carries a risk of distal embolization and no-reflow, whereas deferred stenting may facilitate improved microvascular recovery. This study compared angiographic and echocardiographic outcomes of immediate versus deferred stenting using three-dimensional speckle tracking echocardiography (3D-STE).<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n In this randomized clinical trial, 115 STEMI patients with high thrombus burden were allocated to immediate stenting (\n n<\/jats:italic>\n = 60) or deferred stenting after dual antiplatelet therapy plus enoxaparin (\n n<\/jats:italic>\n = 55). Primary endpoints were final thrombolysis in myocardial infarction (TIMI) flow, myocardial blush grade (MBG), and left ventricular ejection fraction (LVEF) by 3D-STE. Secondary endpoints included global strain parameters and major adverse cardiovascular events (MACE) at 6 months.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Deferred stenting achieved higher TIMI III flow (76.4% vs. 60.0%,\n P<\/jats:italic>\n < 0.001) and MBG 3 (63.6% vs. 41.7%,\n P<\/jats:italic>\n = 0.0025). Both groups showed improved LVEF at 6 months, with greater gains in the deferred group (EF change: 14.05% vs. 12.89%,\n P<\/jats:italic>\n = 0.043). Favorable but nonsignificant trends were noted in global longitudinal, circumferential, and radial strain. MACE rates were similar between groups (34.5% vs. 41.7%,\n P<\/jats:italic>\n = 0.45).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Deferred stenting in STEMI patients with high thrombus burden enhanced angiographic reperfusion and improved recovery of left ventricular function without reducing short-term MACE. These findings suggest deferred stenting as a feasible strategy to optimize myocardial reperfusion, warranting larger, long-term trials to evaluate its prognostic impact.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jcecho.jcecho_130_25","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T17:00:36Z","timestamp":1779814836000},"page":"117-123","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Deferred versus Immediate Stenting in ST-segment Elevation Myocardial Infarction Patients with High Thrombus Burden: A Randomized Clinical Trial Using Three-dimensional Speckle Tracking Echocardiography"],"prefix":"10.4103","volume":"36","author":[{"given":"Ahmed Saeid","family":"Eldamanhory","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hesham Hafez Abdelkhalek","family":"Mosa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud Elsaid","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ibrahim","family":"Awadi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham Samir","family":"Roshdy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islam Elsayed","family":"Shehata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"R1-20260527","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/s41572-019-0090-3","article-title":"ST-segment elevation myocardial infarction","volume":"5","author":"Vogel","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20260527","doi-asserted-by":"crossref","first-page":"573","DOI":"10.21037\/atm-21-1130","article-title":"The outcomes in STEMI patients with high thrombus burden treated by deferred versus immediate stent implantation in primary percutaneous coronary intervention:A prospective cohort study","volume":"9","author":"Luo","year":"2021","journal-title":"Ann Transl 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