Short- and long-term mortality for patients undergoing primary angioplastyfor acute myocardial infarction

OBJECTIVES The goal of this study was to learn more about the risk factors and short- and long-term outcomes for primary angioplasty. BACKGROUND Primary angioplasty (direct angioplasty without antecedent throm bolytic therapy) has been an effective alternative to thrombolytic therapy for patients with acute myocardial infarction (AMI). However, most reported studies have been compromised by small sample sizes and short observation times. METHODS New York's coronary angioplasty registry was used to identify New Y ork patients undergoing angioplasty within 6 h of AMI between January 1, 19 93 and December 31, 1996. Statistical models were used to identify signific ant risk factors for in-patient and long-term survival and to estimate long -term survival for all patients as well as various subsets of patients unde rgoing primary angioplasty. RESULTS The in-hospital mortality rate for all primary angioplasty patients was 5.81%. When patients in preprocedural shock (who had a mortality rate of 45%) were excluded, the in-hospital mortality rate dropped to 2.60%. Mor tality rates for all primary angioplasty patients at one year, two years an d three years were 9.3%, 11.3% and 12.6%, respectively. Patients treated wi th stent placement did not have significantly lower risk-adjusted in-patien t or two-year mortality rates. CONCLUSIONS Primary angioplasty is a highly effective option for BMI. (J Am Cell Cardiol 2000;36: 1194-201) (C) 2000 by the American College of Cardio logy.