title: Procedural results and long-term clinical outcomes following coronary stenting in perimyocardial infarction syndromes.
abstract: Initial experiences with coronary stents in acute coronary syndromes have suggested higher risk of ischemic complications and stent thrombosis. We evaluated in-hospital and 1-year clinical outcomes of coronary stent implantation in perimyocardial infarction (MI) syndromes. We studied 334 consecutive patients undergoing stent interventions in the first week after acute MI. Stenting was performed within 24 hours (n = 31), within 1 to 3 days (n = 95), and within 4 to 7 days (n = 208). Stents were used to improve angioplasty results and to treat dissections and abrupt/threatened closure. Postprocedure anticoagulation regimens were aspirin, ticlopidine, and low molecular weight heparin. Overall procedural success was achieved in 93% of patients. Major in-hospital complications included death (1.0%), recurrent Q-wave MI (0.6%), and emergent bypass surgery (3.0%). Stent thrombosis occurred in 0.6% of patients. At follow-up, cardiac event-free survival was 80%, mortality 2.2%, recurrent MI 3.5%, and target lesion revascularization 11%. We conclude that coronary stenting in periinfarction syndromes was effective in achieving sustained clinical benefit up to 1 year with low morbidity and mortality. Thus, stents seem to be a viable therapeutic strategy in patients sustaining perimyocardial infarction syndromes.
authors.affiliation: Cardiac-Catheterization Laboratory, Washington Hospital Center, Washington, DC, USA.
authors.forename: R
authors.initials: R
authors.lastname: Kornowski
authors.forename: M K
authors.initials: MK
authors.lastname: Hong
authors.forename: J
authors.initials: J
authors.lastname: Saucedo
authors.forename: L F
authors.initials: LF
authors.lastname: Satler
authors.forename: A D
authors.initials: AD
authors.lastname: Pichard
authors.forename: K M
authors.initials: KM
authors.lastname: Kent
authors.forename: A
authors.initials: A
authors.lastname: Greenberg
authors.forename: M B
authors.initials: MB
authors.lastname: Leon
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011336:Probability; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D013988:Ticlopidine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D001241:Aspirin