Primary coronary angioplasty and stent implantation in acute myocardial infarction. Comparative analysis of the in-hospital results in the CENIC/SBHCI registry. National Center of Cardiovascular Interventions members.
OBJECTIVE
Comparative analysis of the in-hospital results after primary implantation of stents or coronary balloon angioplasty in patients with acute myocardial infarction (MI).


METHODS
CENIC (National Center of Cardiovascular Interventions) gathered data on 3, 924 patients undergoing coronary angioplasty (in the primary form, without the previous use of thrombolytic agents) in the first 24 hours after a MI, during the period of 1996-1998. From these 3,924 patients, 1,337 (34%) underwent stent implantation. We analyzed the success of the procedure and the occurrence of adverse cardiac events.


RESULTS
In patients undergoing stent implantation there were more males (77% vs 69%, p=0.001), previous by pass surgery (6. 3% vs. 4.5%, p=0.01), anterior MI and stent implantation in left descending artery (55% vs. 48% vs. p=0.009), and saphenous vein bypass grafts (3.3% vs. 1.9%). the procedure was more succesful in the group of stents (97% vs. 84%, p=0.001) and reinfarction rate (2. 5 vs. 4%, p=0.002). The need for emergency revascularization was similar (1% vs. 1.1%, NS). Total in-hospital mortality was lower in stent group (3.4% vs. 7. 2%, p=0.0001) and this effect was in patients Killip class III/V (19.5% vs. 32.5%, p= 0.002) because there was no difference in patients class I/II (1.7% vs. 2.8%, p=0. 9).


CONCLUSIONS
Primary stent implantation in acute myocardial infarction showed better early results than balloon angioplasty alome.
Mattos
L A
LA
Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP, 04080-003, Brazil.
Sousa
A G
AG
Neto
C C
CC
Labrunie
A
A
Alves
C R
CR
Saad
J
J
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D012042:Registries; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome