Angiographic Iongterm follow-up after coronary stent implantation in acute myocardial infarction

Stent implantation in acute myocardial infarction(AMI)has been shown to improvethe acute angiographic outcomes.So far few data on long-term angiographic follow-up are avallble.Methods:We studied 130 consecutive patients(mean age 58±11,24 women)betweenOctober 1993 and October 1997,in whom coronary stonts were implanted afterunsuccessful percutaneous transluminal coronary angioplasty (PTCA)in AMI.Quantitative coronary angiography(QCA)was performed and residual stenosis wasmesuremesured for all patients immediately and for 74 patients at a mean of 6 months afterthat procedure.Results:The infarct related artery was the left anterior dascending in 60(46%)pts,the circumflex in 15(12%)and the right coronary artery in 55(42%).At baseline,72(55%)pts had a totally occluded artery(TLMI0)and 11(8%)TIMI 1 flow. Eight(6%) pte were given aboiximab(ReoPro) or thrombolyais to deal with acute slantthrombosis during the intervention.Immedately after stent implantation,angiographicsuccess(TLMI 3)was obtained in 113(87%)pts,TLMI2 in 14 (11%)and TLMI 1 intwo (2%). Only three pts had residual stonosis(≥50% stenosis)immediately aftertreatment.Except the patients who had coronary artery bypass grafting(CABG)ordied coronary angiographic follow-up was performed in 74(70%)pts at a mean of 6months following the intervention(Table).Conclusion:Rescue stent implantation after failed PTCA in AMI may improve initialangiographic results,but we found a higher restenosis-rate and reintervention-rate inthe long-term run as compared with selectiv stent implantation.