title: Nonrandomized comparison between stent deployment and percutaneous transluminal coronary angioplasty in acute myocardial infarction.
abstract: BACKGROUND
  Compared with angioplasty, elective stent implantation has improved short-term and long-term outcome with a decrease in abrupt closure and a reduced 6-month restenosis rate. Although primary angioplasty during acute myocardial infarction has improved outcome, recurrent ischemic events and restenosis are still a problem.
  
  
  METHODS
  Outcomes for 166 consecutively treated patients who underwent stent insertion procedures within 24 hours after the onset of acute myocardial infarction were compared with those for a similar group of patients (n = 212) who underwent consecutive balloon angioplasty procedures at one tertiary care institution. The objective of this study was to examine in-hospital and late clinical outcomes for the 2 groups.
  
  
  RESULTS
  The procedural success rate for stenting in acute myocardial infarction was 100%; that for angioplasty was 98%. Mortality rates during hospitalization were similar for the stent group and the angioplasty group (4.0% vs 2.0%). The rate of in-hospital acute reocclusion necessitating urgent percutaneous reintervention was significantly lower for the stent group (0% vs 3%, P =.02). Six months after the procedure, the stent group had a significantly lower need for revascularization of the infarct-related artery (8% vs 20%, P =.001) and a significantly lower incidence of combined serious clinical events (death, acute occlusion, emergency bypass, target vessel revascularization, and nonfatal myocardial infarction; 12% vs 30%, P =.00003).
  
  
  CONCLUSIONS
  Compared with balloon angioplasty, stent deployment in the setting of acute myocardial infarction was associated with significantly lower frequency of in-hospital acute occlusion and significantly less need for target-vessel revascularization 6 months after myocardial infarction.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, North Shore University Hospital, Manhasset, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Katz
authors.forename: S J
authors.initials: SJ
authors.lastname: Green
authors.forename: B M
authors.initials: BM
authors.lastname: Kaplan
authors.forename: L
authors.initials: L
authors.lastname: Chepurko
authors.forename: B G
authors.initials: BG
authors.lastname: Goldner
authors.forename: L
authors.initials: L
authors.lastname: Ong
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012086:Reoperation; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome