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Published on: April 25, 2014
[Angioplasty in acute myocardial infarction. Early and late results]
H Ugalde1, A Ramírez, D Benavente
1Laboratorio Hemodinamia, Hospital Clínico Universidad de Chile.
Insights
Coronary angioplasty is a useful treatment for acute myocardial infarction, showing good long-term outcomes. Most patients remained asymptomatic and event-free after the procedure.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
Context:
- Acute myocardial infarction (AMI) management.
- Limited data on long-term angioplasty outcomes.
Purpose:
- Evaluate early and late outcomes of coronary angioplasty in AMI patients.
- Assess the long-term efficacy of angioplasty for acute myocardial infarction.
Summary:
- Retrospective analysis of 70 AMI patients undergoing angioplasty.
- 83% angiographic success; 6% required revascularization.
- 13% mortality (cardiogenic shock); 80% asymptomatic at follow-up.
Impact:
- Coronary angioplasty demonstrates therapeutic utility in acute myocardial infarction.
- Procedure offers favorable long-term results for selected patients.
- Highlights the importance of addressing ventricular failure and revascularization success for mortality reduction.
Background:
The usefulness of angioplasty in the first hours of an acute myocardial infarction is widely demonstrated. However, its long term effects are less well known.
Aim:
To report the effects of coronary angioplasty on early and late outcome of patients with acute myocardial infarction.
Patients And Methods:
A non-randomized, consecutive and retrospective analysis of the hospital and late outcome of 70 patients, aged 35 to 85 years, subjected to coronary angioplasty during an acute myocardial infarction. Patients were followed during 12 to 60 months.
Results:
Angioplasty was performed 5.3 +/- 5 hours after the initial symptoms. Anterior descendent artery was occluded in 63% of patients with a 99.5% luminal occlusion and TIMI 0-1 anterograde flow. An angiographic success was achieved in 83% of procedures with a residual stenosis of 32.3%. Recurrent ischemia was observed in 6% of patients, that were treated with a new revascularization procedure. Thirteen percent of patients died, all due to cardiogenic shock. Severe ventricular failure and failure of revascularization influenced mortality. During the first year of follow up there was a 3.3% mortality and 3.3% of patients required a new revascularization procedure. Eighty percent of patients were asymptomatic and event-free.
Conclusion:
Angioplasty was a useful therapeutic procedure in this group of patients.
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