ABSTRACT
Coronary stent implantation is an effective treatment of acute myocardial infarction. Little is known about long-term follow-up of patients undergoing stent implantation in the setting of acute myocardial infarction, since most studies restrict the follow-up to six months. The aim was to investigate the clinical follow-up of patients over a period of three years and to identify predictive factors of an adverse cardiovascular outcome. The study retrospectively analyzes a consecutive series of 204 patients receiving stent implantation in the setting of an acute myocardial infarction. Follow-up angiography was performed after 5+/-2 months following myocardial infarction analyzing the incidence of angiographic restenosis. Adverse cardiovascular outcome was defined as cumulative end point including death, myocardial infarction, coronary artery bypass grafting and PTCA/stent implantation of the target vessel occurring in the first three years following myocardial infarction. Multivariate analysis correlated clinical, procedural and angiographic variables with an adverse outcome. Restenosis occurred in 38% of patients. An adverse outcome was observed in 42% of patients. Multivariate analysis identified target vessel CABG, time to treatment >10 h, TIMI flow <3 after stent implantation, number of stents >1, male gender, multivessel disease and arterial hypertension as independent predictors of an adverse cardiovascular outcome. Critical consideration of these risk factors may help to identify patients who are poor candidates for stent implantation in acute myocardial infarction. However, further investigation is required to corroborate the results of this investigation on determinants of a three year follow-up after stent implantation in acute myocardial infarction.
