The clinical efficacy of long coronary stenting after acute myocardial infarction

Objective To evaluate clinical efficacy of primary intracoronary long stenting in infarct related artery with long or diffuse disease after acute myocardial infarction (AMI) Methods The study population was composed of 105 consecutive patients with AMI and attempted primary stent implantation Fifty seven patients with long or diffuse infarct related artery disease after AMI were implanted long intracoronary stents which lengths were equal to or more than 20 mm (group A), and 48 patients with infarct related artery disease which stent lengths was less than 20 mm were as control group (group B) Results The age, gender, onset of chest pain, location of AMI, Killip class, the number of coronary artery disease, individual infarct related artery, TIMI grade before PTCA between two groups were not significantly different The collateral circulation,severe dissection after PTCA of group A were more than group B The length of stents in group A was longer than group B[(26 02±4 77)mm vs (16 02±2 40)mm, P 0 001], and stent diameter was not different in these two groups The procedural success rate of group A was similar to group B (96 5% vs 95 7%, P 0 05) TIMI grade 3 after stent placement between two groups was also not different (93 0% vs 91 7%, P 0 05) One patient of group A had in stent thrombosis after procedure Fifty one patients of group A and 41 of group B were followed up (from 1 to 39 months) after procedure, and 48 of group A and 37 of group B without cardiac events, such as death, AMI 3 patients of group A and 4 of group B were repeated coronary angiography because of chest pain There were 1 patient with restenosis and 2 with severe stenosis in non infarct related artery in group A, and 1 with restenosis and 3 with severe stenosis in non infarcted related artery in group B Conclusion Compared with short stenting in short lesions, long coronary stenting in long or diffuse infarct related artery disease after AMI is the same as a high procedure success rate, low complication and good clinical outcomes