Short and Intermediate Clinical Outcome After Late Coronary Stenting in Myocardial Infarction
PREECHA UEROJANAUNGKUL, M.D.*, CHUMPOL PIAMSOMBOON, M;D.*, CHANWIT ROONGSRITONG, M.D.*, PRASART LAOTHAVORN,M.D.*, CHANNARONG NAKSA WASDI, M.D.*, SOPON SANGUANWONG, M.D.*, PRAVIT TANPRASERT, M.D.*
Affiliation : * Division of Cardiovascular Disease, Department of Medicine, Phramongkutklao College of Medicine, Bangkok 10400, Thailand.
Method : Between June 1998 and August 1999, one hundred and twenty-three patients with AMI, and forty-four patients (37 males, 7 females) underwent late coronary stenting. Mean age was 57 ± I 0 years. Echocardiography was performed before the procedure and at 6-months follow-up.
Results : There were 36 Q-MI and 8 non Q-MI. The infarct-related artery (IRA) was left anterior descending artery (LAD) 55 per cent, left circumflex artery (LCX) 15 per cent, and right coronary artery (RCA) 30 per cent. Coronary stenting was successfully performed in all patients. Pre and post-procedural diameter stenosis were 90.5 ± 8.9 per cent and 2.2 ± 6.5 per cent. Stent indica tions were suboptimal results (68.2%), intimal dissection (20.4%), and acute closure (11.4%). Over all in-hospital mortality was 2.27 per cent from sudden cardiac death. Mean follow-up was 11.41 ± 4.79 months. There were 1 MI (2.3%), 2 CHF (4.65%), 1 unstable angina pectoris (2.3%), 1 transient ischemic attack (TIA) (2.3% ), and no cardiac death. L VEF showed improvement at 6-months follow-up (47.75 ± 11.55% vs 54.89 ± 14.76%, p value < 0.001)
Conclusion : Late coronary stenting of the IRA of patients with AMI is feasible, with few complications. There was improved L VEF and intermediate clinical outcome.
Keywords : Late Reperfusion, Open Artery Theory, Intracoronary Stenting, Echocardiography
