Popis: |
A series of 149 consecutive patients admitted for myocardial infarction (excluding cardiogenic shock), dilated and systematically stented in the acute phase before the 12th hour and followed up for a period from 30 days to 2 years, was studied. The criteria of follow-up were: number of asymptomatic patients, deaths, reinfarction, residual ischaemia, cardiac failure, angioplasty or bypass surgery. On admission, 40.9% of the infarcts were anterior, 44.3% inferior and 14.8% lateral. One hundred and eighty-three stents with a diameter of over 3 mm were inserted. The angioplasty success rate was 98.6%. During the hospital period, 90.6% of patients were asymptomatic. 4.7% had recurrent infarction, 4% had cardiac failure, 0.7% had residual ischaemia, and there were 0.7% of cardiac deaths. The survival rate was 97.2% at 2 years: 69.8% of patients were totally asymptomatic: the cumulative major cardiac event rate (death, reinfarction, angioplasties or bypass graft) was 25.9% and the reoperation rate on the culprit vessel was 20.1%. These results show the short and long-term value of angioplasty associated with coronary stenting over other techniques in the acute phase of infarction based on the criteria studied. The long-term results of larger randomised studies using glycoprotein inhibitors (Gp IIb IIIa) associated with angioplasty and stenting are expected for validating the use of these products. |