Rapid sealing of coronary perforations using polytetrafluoroethylene-covered stents

Abstract

that the benefit of stenting plus abciximab is not restricted to patients with anterior wall AMI, but is also present in patients with nonanterior wall AMI. Stenting plus abciximab salvaged approximately 50% to 60% of the myocardium at risk regardless of the AMI location, whereas the relative salvage was only about 25% to 35% in patients randomized to thrombolysis. The increase in salvaged myocardium with stenting plus abciximab resulted in significantly smaller infarct sizes regardless of infarct location. Furthermore, although the 2 trials were not designed to evaluate the effect of stenting plus abciximab on survival, the AMI-free survival at 1 year was significantly improved in patients with anterior wall AMI, and there was also a clear trend in patients with nonanterior wall AMI. This obvious trend in patients with nonanterior wall AMI is not surprising taking into account the 58% increase in myocardial salvage and the 29% decrease in final infarct size associated with stenting. In conclusion, this analysis of the STOPAMI 1 and 2 trials demonstrates that stenting plus abciximab compared with thrombolysis with or without concomitant abciximab results in a significantly increased myocardial salvage in patients with anterior wall as well as nonanterior wall AMI. In patients with nonanterior wall AMI, increased myocardial salvage associated with stenting is expected to translate into a survival advantage that needs to be confirmed by larger trials.