title: A comparative analysis of primary stenting and optimal balloon coronary angioplasty in acute myocardial infarction. Six month results from the STENT PAMI trial.
abstract: OBJECTIVE
  To compare the outcome of balloon PTCA with final coronary stenosis diameter (SD) < or =30 %, with elective coronary stenting.
  
  
  METHODS
  We performed a comparative analysis of the 6 month outcomes in patients treated with primary stenting and those who obtained an optimal balloon PTCA result treated during the first 12 hours of AMI onset included in the STENT PAMI randomized trial.
  
  
  RESULTS
  The results were analysed into 3 groups: primary stenting (441 patients, SD=22+/-6 %), optimal PTCA (245 patients), and non-optimal PTCA (182 patients, SD= 37+/-5 %). At the end of the 6 months primary stent group presented with the lowest restenosis(23 vs. 31 vs. 45 %, p=0.001, respectively). Ischemia-driven target vessel revascularization rate (TVR) (7 vs. 15.5 vs. 19 %, p=0.001, respectively).
  
  
  CONCLUSIONS
  At the 6 month follow-up, primary stenting offered the lowest restenosis and ischemia-driven TVR rates. Compared to optimal balloon PTCA. Non-optimal primary balloon PTCA pts (SD=31-50 %), had the worst late angiographic outcomes and should be treated more actively with coronary stent implantation.
authors.affiliation: Division of Interventional Cardiology, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil. pivmattos@uol.com
authors.forename: L A
authors.initials: LA
authors.lastname: Mattos
authors.forename: C L
authors.initials: CL
authors.lastname: Grines
authors.forename: D
authors.initials: D
authors.lastname: Cox
authors.forename: J E
authors.initials: JE
authors.lastname: Sousa
authors.forename: C
authors.initials: C
authors.lastname: Costantini
authors.forename: G
authors.initials: G
authors.lastname: Stone
authors.forename: M C
authors.initials: MC
authors.lastname: Morice
authors.forename: W
authors.initials: W
authors.lastname: O'Neill
authors.forename: E
authors.initials: E
authors.lastname: Garcia
authors.forename: J
authors.initials: J
authors.lastname: Boura
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011897:Random Allocation; D015607:Stents; D016896:Treatment Outcome