Long-term outcome of acute myocardial infarction patients treated with stents versus balloon angioplasty: Results from randomized trials

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• 作者：Hideaki Kaneda ; Yoshitaka Hiroe ; Shinji Tanaka ; Takaaki Shiono ; Hideko Inaba ; Yusuke Miyashita ; Saeko Takahashi ; Yoshio Taketani ; Hiroshi Domae ; Junya Matsumi ; Shigeru Saito
• 刊名：International Journal of Cardiology
• 出版年：2009
• 出版时间：3 April 2009
• 年：2009
• 卷：133
• 期：2
• 页码：241-244
• 全文大小：186 K

文摘

Aim

To examine the impact of primary stent implantation versus balloon angioplasty on long-term outcome (median 8 years) in 117 patients with ST-elevation myocardial infarction (STEMI) from randomized trials.

Methods

Enrolled patients were those presenting with STEMI within 12 h of symptom onset. Patients were randomized to either Palmaz–Schatz stent implantation (N = 25) or balloon angioplasty (N = 23) between January and November 1996; or Palmaz–Schatz (N = 26), or Cordis coil stent implantation (N = 24) or balloon angioplasty (N = 19) between February 1998 and March 1999.

Results

Patients (67 ± 11 years) arrived to the hospital within median 2.5 h of symptom onset with Killip 1/2/3/4 grade (72/19/7/2 % , respectively). The culprit lesion was located in the left anterior descending (50 % ), right (39 % ), or left circumflex coronary artery (11 % ) with TIMI 0/1/2/3 flow (81/5/12/2 % , respectively). Clinical/angiographic features were comparable between the 2 groups. During follow-up, there was a significant reduction in cardiac mortality in the stent group (5 % ) compared to the angioplasty group (17 % , log-rank test p = 0.04). In addition, the stent group had a lower target lesion revascularization rate (28 % versus 52 % , p = 0.008), and a significantly lower major adverse cardiac event rate (37 % versus 67 % , p = 0.005), than the angioplasty group.

Conclusion

Compared to balloon angioplasty, primary stenting resulted in a sustained beneficial effect on cardiac mortality at 8 years.