title: Clinical and angiographic follow-Up after primary stenting in acute myocardial infarction: the Primary Angioplasty in Myocardial Infarction (PAMI) stent pilot trial.
abstract: BACKGROUND
  Restenosis has been reported in as many as 50% of patients within 6 months after PTCA in acute myocardial infarction (AMI), which necessitates repeat target-vessel revascularization (TVR) in approximately 20% of patients during this time period. Routine (primary) stent implantation after PTCA has the potential to further improve late outcomes.
  
  
  RESULTS
  Primary stenting was performed as part of a prospective study in 236 consecutive patients without contraindications who presented with AMI of <12 hours' duration at 9 international centers. A mean of 1.4+/-0.7 stents were implanted per patient (97% Palmaz-Schatz) at 17.3+/-2.4 atm. During a clinical follow-up period of 7.4+/-2.6 months, death occurred in 4 patients (1.7%), reinfarction occurred in 5 patients (2.1%), and TVR was required in 26 patients (11.1%). By Cox regression analysis, small reference-vessel diameter and the number of stents implanted were the strongest determinants of TVR. Angiographic restenosis occurred in 27.5% of lesions. By multiple logistic regression analysis, the number of stents implanted and the absence of thrombus on the baseline angiogram were independent determinants of binary restenosis.
  
  
  CONCLUSIONS
  A strategy of routine stent implantation during mechanical reperfusion of AMI is safe and is associated with favorable event-free survival and low rates of restenosis compared with primary PTCA alone.
authors: Washington Hospital Center, Washington, DC20010, USA.
authors: G W
authors: GW
authors: Stone
authors: B R
authors: BR
authors: Brodie
authors: J J
authors: JJ
authors: Griffin
authors: C
authors: C
authors: Costantini
authors: M C
authors: MC
authors: Morice
authors: F G
authors: FG
authors: St Goar
authors: P A
authors: PA
authors: Overlie
authors: J J
authors: JJ
authors: Popma
authors: J
authors: J
authors: McDonnell
authors: D
authors: D
authors: Jones
authors: W W
authors: WW
authors: O'Neill
authors: C L
authors: CL
authors: Grines
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D015607:Stents