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OBJECTIVE	The aim of this study was to assess whether deferred stenting might reduce no-reflow and salvage myocardium in primary percutaneous coronary intervention ( PCI ) for ST-segment elevation myocardial infarction ( STEMI ) .
BACKGROUND	No-reflow is associated with adverse outcomes in STEMI .
METHODS	This was a prospective , single-center , randomized , controlled , proof-of-concept trial in reperfused STEMI patients with 1 risk factors for no-reflow .
METHODS	Randomization was to deferred stenting with an intention-to-stent 4 to 16 h later or conventional treatment with immediate stenting .
METHODS	The primary outcome was the incidence of no - / slow-reflow ( Thrombolysis In Myocardial Infarction 2 ) .
METHODS	Cardiac magnetic resonance imaging was performed 2 days and 6 months after myocardial infarction .
METHODS	Myocardial salvage was the final infarct size indexed to the initial area at risk .
RESULTS	Of 411 STEMI patients ( March 11 , 2012 to November 21 , 2012 ) , 101 patients ( mean age , 60 years ; 69 % male ) were randomized ( 52 to the deferred stenting group , 49 to the immediate stenting ) .
RESULTS	The median ( interquartile range [ IQR ] ) time to the second procedure in the deferred stenting group was 9 h ( IQR : 6 to 12 h ) .
RESULTS	Fewer patients in the deferred stenting group had no - / slow-reflow ( 14 [ 29 % ] vs. 3 [ 6 % ] ; p = 0.006 ) , no reflow ( 7 [ 14 % ] vs. 1 [ 2 % ] ; p = 0.052 ) and intraprocedural thrombotic events ( 16 [ 33 % ] vs. 5 [ 10 % ] ; p = 0.010 ) .
RESULTS	Thrombolysis In Myocardial Infarction coronary flow grades at the end of PCI were higher in the deferred stenting group ( p = 0.018 ) .
RESULTS	Recurrent STEMI occurred in 2 patients in the deferred stenting group before the second procedure .
RESULTS	Myocardial salvage index at 6 months was greater in the deferred stenting group ( 68 [ IQR : 54 % to 82 % ] vs. 56 [ IQR : 31 % to 72 % ] ; p = 0.031 ] .
CONCLUSIONS	In high-risk STEMI patients , deferred stenting in primary PCI reduced no-reflow and increased myocardial salvage .
CONCLUSIONS	( Deferred Stent Trial in STEMI ; NCT01717573 ) .

