Recurrent ischemia in the zone of prior myocardial infarction: results of coronary angioplasty of the infarct-related artery.
We studied the efficacy of coronary angioplasty (PTCA) of the infarct-related artery in 54 patients with recurrent myocardial ischemia in the zone of prior infarction. Our patients had recurrent ischemia 10 +/- 7 days after infarction, with 75% experiencing rest angina and 15% having evidence of reinfarction. Angiography of the infarct-related artery demonstrated a critical stenosis in 35 of 54, a subtotal occlusion in 5 of 54, and a total occlusion in 14 of 54. PTCA was successful in 94% of critical stenoses, 80% of subtotal occlusions, but in only 50% of total occlusions. Complications related to PTCA included a 3.7% rate of emergency surgery, but no deaths or infarctions. During the clinical follow-up period of 11 +/- 7 months, there was one reinfarction and no deaths. Although 27% of our 44 patients with a successful initial PTCA required a second revascularization procedure for recurrent angina, 40 patients (91%) remained symptomatically improved with angioplasty alone (including successful repeat PTCA in eight patients). We conclude that PTCA of the infarct-related artery is beneficial for selected patients with recurrent ischemia in the zone of prior infarction.
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D012008:Recurrence