Background: Primary coronary angioplasty with stent implantation has been considered the treatment of choice in acute myocardial infarction with ST segment elevation, leading to more favorable outcomes and lower incidence of complications when compared to other treatments. The efficacy of patient care in routine duty hours and off-hours and the in-hospital course of these patients were analyzed. Methods: Two hundred and seventy-four patients undergoing primary angioplasty between July 2004 and August 2008 were retrospectively analyzed and divided into two groups: those treated during routine duty hours and those treated during off-hours. Clinical and angiographic characteristics, door-to-balloon time, primary angiographic success, and the occurrence of complications were analyzed. Results: Of 274 patients studied, 186 (67.8%) were treated during routine duty hours and 88 (32.2%) were treated during off-hours. Clinical and angiographic characteristics were similar in both periods. Door-to-balloon time at night (64.1 minutes) was lower than at daytime (72.5 minutes). Primary angiographic success was similar (93%) in both shifts. There was a greater number of major complications at night due to stroke (0% vs. 3.4%; P = 0.032), reinfarction (1% vs. 5.6%; P = 0.037) and target lesion revascularization (1% vs. 5.6%; P = 0.037). Conclusion: At our service, medical care provided in the off-hours was quick and effective with angiographic success rates similar to those obtained in routine duty hours. However, clinical com-

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Relato de Caso RESUMO É relatado o caso de um paciente de 58 anos, submetido a cirurgia de revascularização há 4 meses, com história de aortite, evoluindo com angina instável e apresentando lesão significativa na bifurcação de ponte de veia safena em "Y" com anastomoses sequenciais. O paciente foi submetido com sucesso a implante de stent eluidor de paclitaxel no óstio da derivação da ponte para o ramo descendente posterior e ramo marginal da circunflexa. DESCRITORES: Stents. Angioplastia transluminal percutânea. Ponte de artéria coronária. Veia safena.