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KMID : 0368119990290010028
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Korean Circulation Journal
1999 Volume.29 No. 1 p.28 ~ p.35
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Mid-term Clinical & Angiographic Outcomes of Primary Stenting in Acute Myocardial Infarction
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최광호/Koang Ho Choi
문성기/김원호/고재기/채제건/Sung Ki Moon/Won Ho Kim/Jae Ki Ko/Jei Keon Chae
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Abstract
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Background and Objectives : The goal of this study was to examine the safety and
feasibility of a primary (direct) stenting in acute myocardial infarction (AMI). In the
treatment of AMI, Percutaneous transluminal coronary angioplasty (PTCA) has
documented superior reperfusion rate and improved clinical outcomes than thrombolytic
therapy. However, there are several limitations of PTCA, such as recurrent ischemia in
10 to 15%, reinfarction in 3 to 5% and restenosis in 30 to 50% of patients. There are
several reports that, compared with PTCA, the implantation of coronary stent has been
shown to reduce angiographic restenosis and improve late clinical outcomes. But in
general, stenting has been contraindicated in thrombus containing lesion due to the risk
of subacute thrombosis. With advance in technique and the recognition of the importance
of adequate platelet inhibition, the incidence of subacute thrombosis has fallen in patients
with acute coronary syndrome and thrombus laden lesion.
Methods and Results : In our study, primary stenting was performed in 42 patients of
AMI. There are 6 cases (22.5%) target lesion restenosis during the follow up coronary
angiography (150±86days) and no in-hospital death. Three cases (7.1%) of them require
revascularization including two re-PCTA and a coronary artery bypass graft for the
recurrent ischemic symptoms. There were no reinfarction and death after discharge.
Six-months event free survival rate was 85.7%.
Conclusion : Primary stenting is safe and feasible in the majority of patients with AMI
and results in excellent mid-term outcomes compared with PTCA.
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