Current role of stenting in acute myocardial infarction

Primary infarct artery stenting has the potential to advance treatment of a cute myocardial infarction, The postulated mechanisms of the benefit of ste nting in acute myocardial infarction are the achievement of on acute optima l angiographic result and correction of any residual dissection to decrease the incidence of early and late restenosis and reocclusion and of the corr elated events such as fatal and nonfatal reinfarction and repeat target ves sel revascularization for recurrent ischemia. The results of 5 completed ra ndomized trials corn paring primary stenting with primary percutaneous tran sluminal coronary angioplasty show a lower incidence of the composite end p oint of death, myocardial infarction, and repeat target vessel revasculariz ation in the stent groups as compared with the angioplasty groups and suppo rt the more extensive use of stents in patients with acute myocardial infar ction. The efforts of the next years will be focused on further refinement of stent design and composition and the evaluation of pharmacological agent s effective in restoring myocardial reperfusion to the fullest extent.