Coronary artery stent placement with postprocedural antiplatelet therapy in acute myocardial infarction

Background. We have shown that coronary artery stent implantation in acute myocardial infarction (AMI) is feasible and safe when combined with effective postprocedural antiplatelet therapy. However, the concept of coronary stenting in AMI has not been validated in large cohorts. In this observational study, we investigated the outcome in 318 consecutive patients. Methods and results. From January 1995 until December 1996, 420 of 455 (92.3%) patients admitted to our institutions with AMI underwent infarct artery stent placement. This report describes the 318 patients treated with combined antiplatelet therapy whose AMI was not complicated by cardiogenic shock or mechanical ventilation before the intervention. Postinterventional therapy consisted of 100 mg aspirin and 250 mg ticlopidine twice daily. There were 21 (6.6%) cardiac events during 30-day follow-up: five cardiac deaths (1.6%), four nonfatal re-infarctions (1.3%) and 13 target vessel revascularizations (4.1%). Six months of clinical follow-up yielded a 94.7% survival rate free of repeat AMI. The rate of repeat interventions was 11%. Quantitative computerized angiography at 6 months, performed in 79.4% of the eligible patients, revealed a binary restenosis rate of 25%. Conclusions. With postprocedural antiplatelet therapy, coronary stenting in AMI yields favorable short- and long-term outcomes.