Reduced stent strategy versus conventional percutaneous coronary revascularization in patients presenting with STEMI: the COPERNICAN trial.

Sanz-Sánchez, JorgeSantos Martínez, SandraRumiz González, EvaOteo Domínguez, Juan FranciscoTejada Ponce, DavidGómez Menchero, AntonioSánchez Elvira, GuillermoFuertes Ferre, GeorginaRivero Crespo, FernandoLukic Otanovic, AntonelaDíaz Fernández, JoséGalindo Fernández, EladioUrbano Carrillo, CristóbalSalvatella Giralt, NeusTorres Sánchez, MauricioGarcía Touchard, ArturoIbáñez Cabeza, BorjaStefanini, GiulioAlfonso Manterola, FernandoGarcía García, HéctorAmat-Santos, Ignacio J2025-12-172025-12-172025-05-22Rev Esp Cardiol (Engl Ed). 2025 May 22:S1885-5857(25)00150-1.https://hdl.handle.net/20.500.12105/27071Primary percutaneous coronary intervention (PCI) with drug-eluting stent implantation (DES) is the standard of treatment in patients presenting with ST-segment elevation myocardial infarction (STEMI). However, target lesion failure can occur due to stent underexpansion, malapposition, hypersensitivity, fracture, and neoatherosclerosis. Drug-coated balloons (DCB) represent a potential alternative supported by the concept of "leaving nothing behind." The aim is to compare a reduced stent strategy based on DCB- with DES-PCI in patients presenting with STEMI. Prospective, pragmatic, multicenter, noninferiority, randomized clinical trial. A total of 1 272 patients presenting with STEMI will be randomized to any paclitaxel-DCB vs any sirolimus-DES (both with CE approval) for all culprit and nonculprit lesions during PCI. The primary endpoint will be target-lesion failure: cardiac death, target-vessel myocardial infarction, or ischemia-driven target lesion revascularization at 12-month follow-up. An independent clinical events committee masked to treatment allocation will adjudicate all suspected events. Clinical follow-up will be performed after 1 month (30 days±5 days) and 1 year (365 days±30 days). An extended follow-up at 3, 5, and 10 years is planned. The COPERNICAN trial will be the first randomized study comparing clinical outcomes of DCB vs DES in STEMI patients.engAMhttp://creativecommons.org/licenses/by-nc-nd/4.0/BFABalón farmacoactivoDCBDESDrug-coated balloonDrug-eluting stent implantationIAMCESTInfarto agudo de miocardio con elevación del segmento STSFAST-segment elevation myocardial infarctionSTEMIStent farmacoactivoReduced stent strategy versus conventional percutaneous coronary revascularization in patients presenting with STEMI: the COPERNICAN trial.Attribution-NonCommercial-NoDerivatives 4.0 International40412715REVISTA ESPANOLA DE CARDIOLOGIAopen access