Late restenosis after emergent coronary angioplasty for acute myocardial infarction: comparison with elective coronary angioplasty.
The late restenosis rate after emergent percutaneous transluminal coronary angioplasty for acute myocardial infarction was assessed by performing outpatient follow-up cardiac catheterization in 79 (87%) of 91 consecutive patients who had been discharged from the hospital with a successful coronary angioplasty. The majority of patients (90%) received high dose intravenous thrombolytic therapy with streptokinase in addition to angioplasty. Similar follow-up data were obtained in 206 (90%) of 228 consecutive patients who had successful elective angioplasty during the same period. The interval from angioplasty to follow-up was 28 +/- 9 weeks for the myocardial infarction group and 30 +/- 11 weeks for the elective group. Baseline clinical variables were similar for both the myocardial infarction and elective groups except for a higher percentage of men in the infarction group (81 versus 63%, p = 0.001). The number of coronary lesions undergoing angioplasty and the incidence of intimal dissection were similar, but multivessel angioplasty was more common in the elective group (13 versus 4%, p = 0.02). The rate of in-hospital reocclusion was higher in the patients receiving angioplasty for myocardial infarction (13 versus 2%, p = 0.0001). At the time of late follow-up after hospital discharge, the patients with myocardial infarction were more often asymptomatic (79 versus 55%, p = 0.0001), and the rate of angiographic coronary restenosis was lower for the infarction group both overall (19 versus 35%, p = 0.006) and when multivessel angioplasty patients were excluded (19 versus 33%, p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Simonton
C A
CA
Duke University Medical Center, Durham, North Carolina 27710.
Mark
D B
DB
Hinohara
T
T
Rendall
D S
DS
Phillips
H R
HR
Peter
R H
RH
Behar
V S
VS
Kong
Y
Y
O'Callaghan
W G
WG
O'Connor
C
C
D000368:Aged; D000800:Angioplasty, Balloon; D017023:Coronary Angiography; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D012008:Recurrence; D013300:Streptokinase / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D013300:Streptokinase; D010959:Tissue Plasminogen Activator