title: Safety of coronary stenting early after thrombolysis in patients with acute myocardial infarction: one- and six-month clinical and angiographic evolution.
abstract: 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.
authors.affiliation: Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico-Universitario, Valladolid, Spain. faviles@secardiologia.es
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
authors.forename: Joaquín J
authors.initials: JJ
authors.lastname: Alonso
authors.forename: Federico
authors.initials: F
authors.lastname: Gimeno
authors.forename: Benigno
authors.initials: B
authors.lastname: Ramos
authors.forename: Juan M
authors.initials: JM
authors.lastname: Durán
authors.forename: José
authors.initials: J
authors.lastname: Bermejo
authors.forename: Luis
authors.initials: L
authors.lastname: de La Fuente
authors.forename: Juan C
authors.initials: JC
authors.lastname: Muñoz
authors.forename: Isabel
authors.initials: I
authors.lastname: Garcimartín
authors.forename: Emilio
authors.initials: E
authors.lastname: García-Morán
authors.forename: Olga
authors.initials: O
authors.lastname: Sanz
authors.forename: Ana
authors.initials: A
authors.lastname: Serrador
authors.forename: José A
authors.initials: JA
authors.lastname: San Román
mesh_terms: 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*
chemical_list: D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator