LATE CLINICAL AND ANGIOGRAPHIC FOLLOW-UP AFTER STENTING IN EVOLVING AND RECENT MYOCARDIAL-INFARCTION

Objectives This study sought to assess the late clinical and angiograp hic outcomes of patients who received stents within the first week of acute myocardial infarction (AMI). Background Recent studies have demo nstrated that stenting of the infarct-related artery is a useful adjun ct to balloon angioplasty in patients with AMI. However, there are lim ited data on the late clinical and angiographic outcomes of these pati ents. Methods Between January 1994 and September 1995, 32 patients at our institution underwent stenting of the infarct-related artery withi n 1 week of AMI: 13 within 14 hours (evolving group) and 19 between da ys 2 and 7 (recent AMI group). late clinical follow-up was obtained on all survivors. Quantitative angiographic measurements were recorded o n the stented segments before stenting, immediately after stenting, an d on the follow-up angiograms. Results At 13.1 +/- 6.4 months from the time of stenting, three patients died and three required repeat angio plasty, but no patient had reinfarction or required bypass surgery. At follow-up 26 (81%) of 32 patients remained free of major cardiac even ts; of these, 24 (92%) were free of angina. Repeat angiography perform ed at 10.8 +/- 7.5 months in 26 (87%) of 30 discharged patients showed that all infarct-related arteries were patent and the restenosis rate was low: 22% in the 13 patients with evolving AMI (<14 hours) and 12% in the 19 patients with recent AMI (days 2 through 7). Conclusion In this study stenting of the infarct-related artery in patients with evo lving and recent AMI was associated with a favorable late clinical out come. Patency of the infarct-related artery was well maintained, and t he restenosis rate was low.