USEFULNESS OF INTRACORONARY STENTING IN ACUTE MYOCARDIAL-INFARCTION

Data on the feasibility, safety, and clinical outcome of intracoronary stenting in acute myocardial infarction (AMI) are limited. This study examined the immediate angiographic results and the early and late ou tcomes in 32 patients who had scenting during AMI. Coronary angiograms recorded at the time of stenting were reviewed with quantitative meas urements obtained on the ''target'' coronary lesion before and offer s tenting. Immediate angiographic success was achieved in 30 patients (9 4%). The minimal luminal diameter increased from 0.36 +/- 0.37 to 2.58 +/- 0.41 mm (p < 0.0001). Two patients died in the hospital. Of the r emainder, none had reinfarction or required bypass surgery, whereas 2 required repeat coronary angioplasty for recurrent ischemia. Although thrombus at the infarct-related coronary lesion was initially defected in 41% of the patients, its presence was not associated with adverse procedural outcome. Only 1 patient had persistent thrombus after stent ing, which resolved with intracoronary urokinase. AZ a mean follow-up of 6.1 +/- 4.1 months, there was 1 additional cardiac death, and no pa tient had AMI dr required repeat coronary angioplasty or bypass; among the 29 survivors, 86% were free of angina. Thus, intracoronary stenti ng of the infarct-related artery in the setting of AMI is associated w ith excellent immediate angiographic success and a favorable clinical outcome, and remains an option even in the presence of thrombus.