Long-term Outcomes of Primary Stenting in Acute Myocaridal Infarction

Abstract

Background and Objectives:Primary coronary stenting has been shown to be an effective reperfusion therapy for acute myocardial infarction (AMI). However, few data exist regarding long-term follow-up. We examine the long-term clinical and angiographic outcomes associated with primary coronary stenting performed after early AMI diagnosis. Methods:Between September 1995 and October 1999, coronary stenting was attempted in 181 consecutive patients who had been admitted and diagnosed with AMI within 6 hours from of the onset of chest pain. The incidence of all post-stenting clinical events, including death, MI, coronary bypass surgery and repeat angioplasty, was recorded for 1 year. Angiograms were obtained at baseline, after stenting, at 2 weeks and 6 months. Results:Of the initial group, 168 patients (92.8%) completed 1 year of clinical follow-up. Inhospital deaths occurred in 5 patients (3%). Follow-up angiography was performed at 6.4±2.1 months after stent implantation in 105 (62.5%) patients and restenosis occurred in 21.9%. Clinical events occurring within 1 year included death (6.5%), myocardial infarction (1.2%), bypass surgery (1.8%) and repeat angioplasty (7.7%). The remaining 82.2% of patients had experienced no adverse cardiac events at 1 year. Conclusion: Primary stenting is safe and feasible in AMI patients, even in large thrombus containing lesions, and it is associated with in excellent long-term outcomes.(Korean Circulation J 2001;31(8):742-748)