Six-month angiographic follow-up after intravascular ultrasound-guided stenting of infarct-related artery: Comparison non-infarct-related artery

Background Compared with balloon angioplasty, stenting has been established as an effective treatment modality to reduce restenosis in patients with a cute myocardial infarction. However, the immediate results that predict fav orable long-term outcomes in the acute infarct stenting are unknown. Theref ore, we evaluated long-term outcomes of stenting for infarct-related artery (IRA) lesions by using intravascular ultrasound (IVUS) compared with that of stenting for non-IRA lesions. Methods IVUS-guided coronary stenting was successfully performed in 510 nat ive coronary lesions (105 IRA vs 405 non-IRA). A 6-month follow-up angiogra m was performed in 419 (82.2%) lesions: 87 (82.9%) IRA lesions and 332 (82. 0%) non-IRA lesions. Coronary stenting on the IRA lesions was successfully performed within 7 to 10 days after onset of infarction in 42 patients and within 12 hours in 45 patients. Results were evaluated by clinical, angiogr aphic, and IVUS methods. Results There were no significant differences in clinical and angiographic variables between the two groups. IVUS variables including reference vessel area and minimal stent area were also similar between the two groups, Ther e was no significant difference in angiographic restenosis rate between the two groups in cases of minimal stent area greater than or equal to7 mm(2): 12.8% (6 of 47) in IRA versus 19.1% (33 of 173) in non-IRA lesions (P = .3 15). However, the angiographic restenosis rate in cases of minimal stent ar ea <7 mm(2) was 50% (20 of 40) in IRA lesions versus 31.5% (50 of 159) in n on-IRA lesions (P = .028). Conclusions Angiographic restenosis is significantly higher in stenting for IRA lesions compared with that for non-IRA lesions in cases of minimal ste nt area <7 mm(2).