Hospital outcome after bailout coronary stenting in patients with acute myocardial infarction.
We evaluated the outcome of bailout coronary stenting in acute myocardial infarction. Fifty patients (35 men, mean age 60 plusmn; 12) with acute myocardial infarction consecutively underwent bailout stenting after primary and rescue coronary angioplasty (n=41 and 9, respectively). Cardiogenic shock was present in six patients, and 17 others had contraindications to thrombolysis. Stent implantation was successful in 49/50 patients. The antithrombotic regimen combined heparin, aspirin, and ticlopidine. One patient had symptomatic stent closure. Predischarge angiography in 41/44 survivors showed widely patent stents in 40/41 patients. Six patients (4 of whom had been admitted with cardiogenic shock) died in the hospital. During acute myocardial infarction, bailout stenting can achieve high TIMI grade 3 coronary patency (here, 92%), and low acute stent closure rates (here, 2%). However, in-hospital mortality remained high, at nearly 10%, mainly due to the severe risk profile in this patient subset.
Department of Cardiology, University Hospital Bichat, Paris, France.
D
D
Himbert
J M
JM
Juliard
H
H
Benamer
L J
LJ
Feldman
P
P
Aubry
P G
PG
Steg
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D019233:Retreatment; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D015607:Stents; D015996:Survival Rate; D015912:Thrombolytic Therapy; D017211:Treatment Failure; D016896:Treatment Outcome