title: Coronary Palmaz-Schatz stent implantation in acute myocardial infarction.
abstract: OBJECTIVE
  To investigate the feasibility of coronary stenting in acute myocardial infarction.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  80 patients undergoing direct balloon angioplasty for acute myocardial infarction who had coronary Palmaz-Schatz stents implanted during a 3 year study period. Indications for stenting were abrupt reocclusion, large dissection with threatened reocclusion, and failure to achieve brisk flow of contrast by angioplasty alone.
  
  
  METHODS
  After stenting, 50 patients were treated by conventional anticoagulation and 30 patients received antiplatelet therapy with aspirin and ticlopidine.
  
  
  METHODS
  Death and subacute reocclusion within two weeks.
  
  
  RESULTS
  Coronary stenting fully restored vessel patency in 79 patients (98.8%). 10 of 14 patients with symptoms of Killip class IV on admission were discharged from hospital alive. Three of the 66 patients with symptoms of Killip classes I-III died in hospital. Repeat angiography in 59 of these patients, showed 3 symptomatic and 2 silent reocclusions (reocclusion rate 8.5%). No stent thromboses were detected in patients treated with ticlopidine.
  
  
  CONCLUSIONS
  Coronary stenting is a safe and effective treatment for complicated direct balloon angioplasty in acute myocardial infarction. In patients with symptoms of Killip classes I to III the risk of subacute reocclusion is comparable to that of bail-out stenting after elective balloon angioplasty.
authors.affiliation: Medizinische Klinik, Technische Universität München, Germany.
authors.forename: F J
authors.initials: FJ
authors.lastname: Neumann
authors.forename: H
authors.initials: H
authors.lastname: Walter
authors.forename: G
authors.initials: G
authors.lastname: Richardt
authors.forename: C
authors.initials: C
authors.lastname: Schmitt
authors.forename: A
authors.initials: A
authors.lastname: Schömig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003328:Coronary Thrombosis / Q000601:surgery; D003331:Coronary Vessels / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery* / Q000628:therapy; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome