Angioplastia coronariana primária e implante de stents no infarto agudo do miocárdio: análise comparativa dos resultados hospitalares no registro CENIC/SBHCI / Primary coronary angioplasty and stent implantation in acute myocardial infarction: comparative analysis of the in-hospital results in the CENIC/SBHCI registry

ABSTRACT

OBJECTIVE: Comparative analysis of the in-hospital results after primary implantation of stents or coronary balloon angioplasty in patients with acute myocardial infarction (MI). METHODS: CENIC (National Center of Cardiovascular Interventions) gathered data on 3,924 patients undergoing coronary angioplasty (in the primary form, without the previous use of thrombolytic agents) in the first 24 hours after a MI, during the period of 1996-1998. From these 3,924 patients, 1,337 (34 per cent) underwent stent implantation. We analyzed the success of the procedure and the occurrence of adverse cardiac events. RESULTS: In patients undergoing stent implantation there were more males (77 per cent vs 69 per cent, p=0.001), previous by pass surgery (6.3 per cent vs. 4.5 per cent, p=0.01), anterior MI and stent implantation in left descending artery (55 per cent vs. 48 per cent vs. p=0.009), and saphenous vein bypass grafts (3.3 per cent vs. 1.9 per cent). the procedure was more succesful in the group of stents (97 per cent vs. 84 per cent, p=0.001) and reinfarction rate (2.5 vs. 4 per cent, p=0.002). The need for emergency revascularization was similar (1 per cent vs. 1.1 per cent, NS). Total in-hospital mortality was lower in stent group (3.4 per cent vs. 7. 2 per cent, p=0.0001) and this effect was in patients Killip class III/V (19.5 per cent vs. 32.5 per cent, p= 0.002) because there was no difference in patients class I/II (1.7 per cent vs. 2.8 per cent, p=0.9). CONCLUSION: Primary stent implantation in acute myocardial infarction showed better early results than balloon angioplasty alome.