Late coronary artery stenting in patients with acute myocardial infarction.
BACKGROUND
The safety and efficacy of late coronary artery stenting of the infarct-related artery after acute infarction has not been evaluated previously.


RESULTS
Coronary artery stenting was performed in 117 consecutive patients with acute infarction who were receiving ticlopidine/aspirin regimen without coumarin. There were 97 men and 18 women, aged 58+/-11 (mean +/- SD) years. A total of 136 Palmaz-Schatz stents were successfully implanted in 130 lesions 15+/-8 days after acute myocardial infarction (median 9 days) in 115 of 117 (98%) patients. The minimal luminal diameter (MLD) increased from 0.66+/-0.46 to 3.14+/-0.53 mm (P< .001), with an acute gain of 2.49+/-0.61 mm. One patient had acute thrombosis requiring further stenting and another patient received emergency bypass surgery. There was no subacute thrombosis or other complications. During a follow-up duration of 14+/-3 months, 2 patients had angina pectoris develop and 1 died suddenly. Sixty-two patients underwent a follow-up coronary angiography 195+/-36 days after stenting. Restenosis was noted in 8 patients (13%); the MLD was 2.19+/-0.73 mm, the late loss was 0.96+/-0.65 mm (P< .001), the loss index was 0.39+/-0.28, and the net gain was 1.56+/-0.79 mm (P< .001). The angiographic left ventricular ejection fraction increased from 47%+/-12% to 55%+/-12% (P< .001).


CONCLUSIONS
Late coronary stenting of the infarct-related artery in patients with acute myocardial infarction is a safe and effective late reperfusion therapy and may be beneficial to the patients.
Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan, Republic of China.
I C
IC
Hsieh
H J
HJ
Chang
M S
MS
Chern
K C
KC
Hung
F C
FC
Lin
D
D
Wu
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D015425:Myocardial Reperfusion; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome