In patients with acute myocardial infarction, stenting within 48 hours resulted in 72% of patients being free of major adverse cardiac events at one year.
Suggests early stenting may yield acceptable 1-year outcomes in AMI with identifiable risks; leaves open need for randomized confirmation.
We retrospectively review our results of 96 stent placements in 64 patients identified from our data base who received stents acutely and within 48 hr of acute myocardial infarction. The average age was 60 years; 77% were male. The average length of stay was 6.75 days. Three patients needed coronary artery bypass grafting (CABG) before discharge: 2 for stent occlusion and 1 for papillary muscle rupture. Need for CABG, further percutaneous transluminal coronary angioplasty (PTCA), myocardial infarction, and death defined outcome. Mean patient follow-up was 10.3 (+/-5.3) months. Seventy-two percent of patients were free of outcome events at 1 year, 17% needed CABG, and 11% required further PTCA. There were 2 myocardial infarctions and 1 death. Presence of left bundle branch block on admission electrocardiogram and angina in hospital after stent placement predicted worse outcome (P < 0.01).
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Berland et al. (1997) studied this question.
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