Direct infarct artery stenting without predilation and no-reflow in patients with acute myocardial infarction.

Abstract:

BACKGROUND:In patients with acute myocardial infarction (AMI), the rate of microvascular embolization and no-reflow promoted by coronary stenting with the use of conventional techniques (CS) appears to be greater than the one that occurs with balloon angioplasty. The minor invasiveness of direct stenting (DS) of the infarct artery without predilation could be expected to reduce embolization in the coronary microvasculature and no-reflow in patients with AMI. METHODS:In a cohort of 423 consecutive patients with AMI who underwent infarct-artery stenting, we compared CS and DS in terms of angiographic no-reflow rate and 1-month clinical outcome. RESULTS:At baseline patients who underwent DS (n = 110) had a better risk profile compared with the use of CS (n = 313). The incidence of angiographic no-reflow was 12% in the CS group and 5.5% in the DS group (P =.040). The 1-month mortality rate was 8% in the CS group and 1% in the DS group (P =.008). The mortality rate was 11% in patients with no-reflow and 5.6% in patients with a normal flow. Multivariate analysis showed that age, preprocedure patent infarct artery, and lesion length were related to the risk of no-reflow. In the subset of patients with a target lesion length

journal_name

Am Heart J

journal_title

American heart journal

authors

Antoniucci D,Valenti R,Migliorini A,Moschi G,Bolognese L,Cerisano G,Buonamici P,Santoro GM

doi

10.1067/mhj.2001.117778

subject

Has Abstract

pub_date

2001-10-01 00:00:00

pages

684-90

issue

4

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(01)40674-0

journal_volume

142

pub_type

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