<b>Does Coronary Artery Stenting for Acute Myocardial Infarction Improve Left Ventricular Overloading at the Chronic Stage?</b>

Abstract

SUMMARYIn the present study, we evaluated whether stenting is useful for cardiac overloading, using ANP, BNP, and 99m Tc-tetrofosmin myocardial scintigraphy. It has been reported that coronary artery stenting is useful for cardiac functions for acute myocardial infarction (AMI). The subjects were 110 patients with AMI successfully treated by direct angioplasty. These patients were subgrouped into two groups: the S group (underwent stenting; 54 patients) and the P group (underwent POBA alone; 56 patients). Extent scores reflecting decreased myocardial blood flow were calculated at myocardial areas showing a radioactivity count of less than -2 × standard deviations compared to the database of normal subjects.The ratio of extent scores to defect scores (extent/defect ratio) was compared between the P and S groups. Both ANP and BNP levels in the S group were lower than in the P group at the chronic stage (1 and 3 months after reperfusion therapy). Moreover, the end-diastolic volume index from the left ventriculography 3 months after reperfusion therapy was significantly larger in the P than the S group. The extent/defect ratio was significantly lower in the P group (2.8 ± 0.2) than the S group (3.5 ± 0.3), suggestive of a microcirculation disorder. These results suggest that cardiac overloading and left ventricular remodeling are decreased more by stenting than by POBA alone, probably because stenting prevents decreased myocardial blood flow around the infarct myocardium. (Jpn Heart J 2004; 45: 217-229)

Long-Term Outcome After Primary Stenting Versus Balloon Angioplasty for Acute Myocardial Infarction Five-year Follow-up of a Case-control Study

“…[5][6][7] Moreover, previously published data indicate that primary stenting in acute myocardial infarction may be effective for preventing myocardial injury and preserving regional wall motion and left ventricular function and remodeling. 8,9) The long-term outcome after an acute myocardial infarction is related to left ventricular function. Therefore, to test the effects of primary stenting on the long-term (5years) clinical outcome in patients with acute myocardial infarction, we performed a comparative case-control study between successful cases of primary PTCA with and without stenting at 7 cardiovascular centers belonging to the Network of Revascularization Therapy in Hokkaido (NORTH) group of investigators.…”