Late coronary artery stenting in patients with acute myocardial infarction, , ,

Background The safety and efficacy of late coronary artery stenting of the infarct-related artery after acute infarction has not been evaluated previously. Methods and Results Coronary artery stenting was performed in 117 consecutive patients with acute infarction who were receiving ticlopidine/aspirin regimen without coumarin. There were 97 men and 18 women, aged 58 ± 11 (mean ± SD) years. A total of 136 Palmaz-Schatz stents were successfully implanted in 130 lesions 15 ± 8 days after acute myocardial infarction (median 9 days) in 115 of 117 (98%) patients. The minimal luminal diameter (MLD) increased from 0.66 ± 0.46 to 3.14 ± 0.53 mm (P < .001), with an acute gain of 2.49 ± 0.61 mm. One patient had acute thrombosis requiring further stenting and another patient received emergency bypass surgery. There was no subacute thrombosis or other complications. During a follow-up duration of 14 ± 3 months, 2 patients had angina pectoris develop and 1 died suddenly. Sixty-two patients underwent a follow-up coronary angiography 195 ± 36 days after stenting. Restenosis was noted in 8 patients (13%); the MLD was 2.19 ± 0.73 mm, the late loss was 0.96 ± 0.65 mm (P < .001), the loss index was 0.39 ± 0.28, and the net gain was 1.56 ± 0.79 mm (P < .001). The angiographic left ventricular ejection fraction increased from 47% ± 12% to 55% ± 12% (P < .001). Conclusions Late coronary stenting of the infarct-related artery in patients with acute myocardial infarction is a safe and effective late reperfusion therapy and may be beneficial to the patients. (Am Heart J 1998;136:606-12.)