Primary angioplasty associated with systematic coronary stenting in acute myocardial infarction. Series of 149 patients: Results at the end of the hospital period and at 24 months.

A series of 149 consecutive patients admitted for myocardial infarction (ex cluding cardiogenic shock), dilated and systematically stented in the acute phase before the 12th hour and followed up for a period from 30 days to 2 years, was studied. The criteria of follow-up were : number of asymptomatic patients, deaths, r einfarction, residual ischaemia. cardiac failure, angioplasty or bypass sur gery. On admission. 40.9% of the infarcts were anterior, 44.3% inferior and 14.8% lateral. One hundred and eighty-three stents with a diameter of over 3mm were inserted. The angioplasty success rate was 98.6%. During the hospital period. 90.6% o f patients were asymptomatic. 4.7% had recurrent infarction. 4% had cardiac failure. 0.7% had residual ischaemia. and there were 0.7% of cardiac death s. The survival rate was 97.2% at 2 years : 69.8% of patients were totally asymptomatic: the cumulative major cardiac event rate (death, reinfarction. angioplasties or bypass graft) was 25.9% and the reoperation rate on the c ulprit vessel was 20.1%. These results show the short acid long-term value of angioplasty associated with coronary stenting over other techniques in the acute phase of infarct ion based on the criteria studied. The long-term results of larger randomis ed studies using glycoprotein inhibitors (Gp IIb IIIa) associated with angi oplasty and stenting are expected for validating the use of these products.