Improvement in left ventricular function following coronary stenting in patients with acute myocardial infarction: 6-month and 3-year follow-up.
BACKGROUND
This study assesses hemodynamic and angiographic changes in patients with a patent infarct-related artery (IRA) after acute myocardial infarction (AMI).


METHODS
One hundred and seventy-seven patients with first AMI, who received a predischarge stenting to the IRA and sustained a patent IRA over 3 years, were stratified into 3 groups according to the baseline left ventricular ejection fraction (LVEF): group A included 63 patients with a LVEF of >49%, group B 73 patients with a LVEF of 40%-49%, and group C 41 patients with a LVEF of <40%. The hemodynamic and angiographic parameters were compared at baseline, 6-month and 3-year follow-up.


RESULTS
The LV end-diastolic volume index increased 1, 4 and 4 ml/m(2) at 6 months and 4, 5 and 10 ml/m(2) at 3 years, respectively in group A, B and C. The LVEF increased 4%, 7% and 12% at 6 months and 6%, 8% and 14% at 3 years, respectively in group A, B and C. The stroke volume index increased 3, 7 and 12 ml/m(2) at 6 months and 6, 8 and 15 ml/m(2) at 3 years, respectively in group A, B and C. The LV wall motion score decreased 2, 3 and 3 at 6 months and was unchanged at 3 years, respectively in group A, B and C. The LV end-diastolic pressure decreased 2, 3 and 4 mm Hg, respectively in group A, B and C, at 6-month follow-up and remained stable at 3 years.


CONCLUSIONS
Long-term beneficial effects in patients receiving a late predischarge intracoronary stenting following first AMI were seen and these may be related to patent IRA. A progressive improvement in left ventricular remodeling occurs in all patients regardless of their initial left ventricular function and the improvement continues for at least 3 years.
Hsieh
I-Chang
IC
Second Section of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Tapei, Taiwan.
Huang
Hsuan-Li
HL
See
Lai-Chu
LC
Chang
Shang-Hung
SH
Chang
Hern-Jia
HJ
Hung
Kuo-Chun
KC
Lin
Fun-Chung
FC
Wu
Delon
D
D000368:Aged; D002320:Cardiovascular Physiological Phenomena; D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000601:surgery*; D015607:Stents; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*