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.
Hsieh
I C
IC
Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan, Republic of China.
Chang
H J
HJ
Chern
M S
MS
Hung
K C
KC
Lin
F C
FC
Wu
D
D
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