Long-term Outcomes of Primary Stenting in Acute Myocaridal Infarction

ABSTRACT

BACKGROUND AND OBJECTIVES: Primary coronary stenting has been shown to be an effective reperfusion therapy for acute myocardial infarction(AMI). However, few data exist regarding long-term follow-up. We examine the long-term clinical and angiographic outcomes after primary coronary stenting in the early setting of AMI. METHODS: Between September 1995 to October 1999, coronary stenting was attempted in 181 consecutive patients admitted with the diagnosis of AMI within 6 hours from the onset of the chest pain. Clinical events, including death, MI, coronary bypass surgery and repeat angioplasty, were recorded for 1 year. Angiogram were obtained at baseline, after stent, at 2 weeks and 6 months. RESULTS: 168 patients(92.8%) of all patients had complete 1 year clinical follow-up. In-hospital deaths occured in 5 patients(3%). One hundred five patients(62.5%) had follow-up angiography at 6.4+/-2.1 months after stent implantation and restenosis occured in 21.9%. Clinical events after 1 year included death in 6.5%, myocardial infarction in 1.2%, bypass surgery in 1.8% and repeat angioplasty in 7.7%. Freedom from any adverse cardiac event at 1 year was 82.2%. CONCLUSION: Primary stenting is safe and feasible in patients of AMI, even in large thrombus containing lesion and results in excellent long-term outcomes.