Concomitant anterior ST-segment depression is a marker of severe prognosis in inferior myocardial infarction.Prospective observational study in patients with inferior acute myocardial infarction and ST-segment depression > or = 4 mm in the anterior leads, who were treated with primary angioplasty. Angiography was performed at hospital discharge and at six months, and a clinical follow-up was obtained at one year after the infarction.Sixty-three patients were included in the study. Pre-hospital and in-hospital delay were 147 +/- 70 minutes (20-355) and 54 +/- 11 minutes (18-80), respectively. Angioplasty was successful in all patients and 48 stents were implanted in 36 patients (57\%). Angiography was performed at hospital discharge in 55 patients (87\%) and showed a TIMI grade 3 coronary flow in the infarct-related artery in all cases. The left ventricular ejection fraction was 0.55 +/- 0.09 (0.4-0.8). One patient (1.6\%) died before discharge, two (3.2\%) had ischemic complications (one had non-fatal reinfarction, another had recurrent angina at rest), and three (4.9\%) had local vascular complications. At the six-month follow-up, none of the patients had died. One had suffered reinfarction (1.6\%) and another had been readmitted for recurrence of angina at rest (1.6\%); none had symptoms of stable angina. The ejection fraction was 0.56 +/- 0.12 and eight patients (14\%) showed angiographic restenosis. At twelve months, two patients had died (1.6\%) and five (8\%) had required readmission to hospital.Primary angioplasty yielded favorable results in this group of patients. Our data confirm the efficacy of primary angioplasty for the treatment of acute myocardial infarction, with a low rate of clinical (3.2\%) and angiographic (14\%) restenosis at six months, and a high rate (87\%) of event-free survival at one year follow-up.
[Primary angioplasty in acute inferior myocardial infarct with anterior ST-segment depression: the long-term follow-up].
RIBICHINI, Flavio Luciano;
1998-01-01
Abstract
Concomitant anterior ST-segment depression is a marker of severe prognosis in inferior myocardial infarction.Prospective observational study in patients with inferior acute myocardial infarction and ST-segment depression > or = 4 mm in the anterior leads, who were treated with primary angioplasty. Angiography was performed at hospital discharge and at six months, and a clinical follow-up was obtained at one year after the infarction.Sixty-three patients were included in the study. Pre-hospital and in-hospital delay were 147 +/- 70 minutes (20-355) and 54 +/- 11 minutes (18-80), respectively. Angioplasty was successful in all patients and 48 stents were implanted in 36 patients (57\%). Angiography was performed at hospital discharge in 55 patients (87\%) and showed a TIMI grade 3 coronary flow in the infarct-related artery in all cases. The left ventricular ejection fraction was 0.55 +/- 0.09 (0.4-0.8). One patient (1.6\%) died before discharge, two (3.2\%) had ischemic complications (one had non-fatal reinfarction, another had recurrent angina at rest), and three (4.9\%) had local vascular complications. At the six-month follow-up, none of the patients had died. One had suffered reinfarction (1.6\%) and another had been readmitted for recurrence of angina at rest (1.6\%); none had symptoms of stable angina. The ejection fraction was 0.56 +/- 0.12 and eight patients (14\%) showed angiographic restenosis. At twelve months, two patients had died (1.6\%) and five (8\%) had required readmission to hospital.Primary angioplasty yielded favorable results in this group of patients. Our data confirm the efficacy of primary angioplasty for the treatment of acute myocardial infarction, with a low rate of clinical (3.2\%) and angiographic (14\%) restenosis at six months, and a high rate (87\%) of event-free survival at one year follow-up.
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