Late clinical and angiographic follow-up after stenting in evolving and recent myocardial infarction.
OBJECTIVE
This study sought to assess the late clinical and angiographic outcomes of patients who received stents within the first week of acute myocardial infarction (AMI).


BACKGROUND
Recent studies have demonstrated that stenting of the infarct-related artery is a useful adjunct to balloon angioplasty in patients with AMI. However, there are limited data on the late clinical and angiographic outcomes of these patients.


METHODS
Between January 1994 and September 1995, 32 patients at our institution underwent stenting of the infarct-related artery within 1 week of AMI: 13 within 14 hours (evolving group) and 19 between days 2 and 7 (recent AMI group). Late clinical follow-up was obtained on all survivors. Quantitative angiographic measurements were recorded on the stented segments before stenting, immediately after stenting, and on the follow-up angiograms.


RESULTS
At 13.1+/-6.4 months from the time of stenting, three patients died and three required repeat angioplasty, but no patient had reinfarction or required bypass surgery. At follow-up 26 (81%) of 32 patients remained free of major cardiac events; of these, 24 (92%) were free of angina. Repeat angiography performed at 10.8+/-7.5 months in 26 (87%) of 30 discharged patients showed that all infarct-related arteries were patent and the restenosis rate was low: 22% in the 13 patients with evolving AMI (<14 hours) and 12% in the 19 patients with recent AMI (days 2 through 7).


CONCLUSIONS
In this study stenting of the infarct-related artery in patients with evolving and recent AMI was associated with a favorable late clinical outcome. Patency of the infarct-related artery was well maintained, and the restenosis rate was low.
Le May
M R
MR
Division of Cardiology at the University of Ottawa Heart Institute, Ontario, Canada.
Labinaz
M
M
Marquis
J F
JF
O'Brien
E R
ER
Beanlands
R S
RS
Laramée
L A
LA
Williams
W L
WL
Davies
R F
RF
Kearns
S A
SA
Higginson
L A
LA
D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D015607:Stents; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D000925:Anticoagulants; D005343:Fibrinolytic Agents