Intracoronary Stenting in Patients with Acute Myocardial Infarction

ABSTRACT

BACKGROUND: In elective intervention, the implantation of an intracoronary stent is an established treatment modality to reduce restenosis in comparison with balloon angioplasty. However, stenting was empirically thought to be contraindicated for acute myocardial infarction because of the propensity for thrombosis, althought the percutaneous transluminal coronary balloon angioplasty(PTCA) on infarct-related artery is associated with a high incidence of restenosis. To knowlege, there is no report comparing the longterm efficacy of coronary stenting with PTCA in patients with acute myocardial infarction. Accordingly, we investigated the effect of stent implantation on restenosis of infarct-related artery in acute myocardial infarction, comparing with conventional balloon angioplasty. METHOD: From January 1994 to December 1995, 97 patients (stenting in 45 patients PTCA in 52 patients) underwent intracoronary stenting or PTCA on infarct-related artery successfully at 7-10 days after onset of infarction. The coronary stents were Palmaz-Schatz stent in 35 patients and Cordis stent in 10 patients. Follow-up coronary angiography was performed in all patients 6 months later after intervention. RESULTS: No death, emergency coronary artery bypass surgery or reinfarction occurred during hospitalization in 97 patients. In 45 patients with stent implantation, no stent thrombosisoccurred. The 6-months angiographic restenosis rate was 13 percent in patients assigne to stent implantation and 52 percent in patients assigned to PTCA(p<0.05). CONCLUSION: We conclude that the intracoronary stent implantation on infarct-related artery at 7-10 days after acute myocardial infarction is safe, feasible and significantly reduces the restenosis rate.