Safety of coronary stenting early after thrombolysis in patients with acute myocardial infarction: one- and six-month clinical and angiographic evolution.
To determine the feasibility and safety of early posthrombolysis coronary stenting and the incidence of further reocclusion, we followed 99 consecutive patients with acute myocardial infarction thrombolyzed with rt-PA 2.0 +/- 0.8 hr after onset. Culprit artery was stented 14.0 +/- 7.0 hr after thrombolysis. All patients underwent clinical and angiographic follow-up at 1 and 6 months. Angiographic success was achieved in 99% of cases. Neither major cardiac events nor bleeding or vascular complications occurred during hospital stay. At 30 days, no events occurred and normal flow persisted in all stented arteries. At 6 months, only one artery reoccluded (1%), resulting in a nonfatal reinfarction. Restenosis rate was 21%. Contribution of the infarcted area to left ventricular function significantly increased from baseline to 30-day and to 6-month evaluations. Thus, early posthrombolysis stenting is a safe strategy with a low reocclusion rate, which seems to allow functional recovery of the infarcted area. Further studies are necessary to define its impact on survival and cost-effectiveness.
Fernández-Avilés
Francisco
F
Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico-Universitario, Valladolid, Spain. faviles@secardiologia.es
Alonso
Joaquín J
JJ
Gimeno
Federico
F
Ramos
Benigno
B
Durán
Juan M
JM
Bermejo
José
J
de La Fuente
Luis
L
Muñoz
Juan C
JC
Garcimartín
Isabel
I
García-Morán
Emilio
E
Sanz
Olga
O
Serrador
Ana
A
San Román
José A
JA
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D015331:Cohort Studies; D017023:Coronary Angiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator