Late restenosis after emergent coronary angioplasty for acute myocardial infarction: Comparison with elective coronary angioplasty

Charles A. Simonton, Daniel B. Mark, Tomoaki Hinohara, David S. Rendall, Harry R. Phillips, Robert H. Peter, Victor S. Behar, Yihong Kong, William G. O'Callaghan, Christopher O'Connor, Robert M. Califf, Richard S. Stack

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

The late restenosis rate after emergent percutaneous transluminal coronary angioplasty for acute myocardial infarction was assessed by performing outpatient fallow-up cardiac catheterization in 79 (87%) of 91 consecutive patients who had been discharged from the hospital with a successful coronary angioplasty. The majority of patients (90%) received high dose intravenous thrambolytic therapy with streptokinase in addition to angioplasty. Similar follow-up data were obtained in 206 (90%) of 228 consecutive patients who had successful elective angioplasty during the same period. The interval from angioplasty to follow-up was 28 ± 9 weeks for the myocardial infarction group and 30 ± 11 weeks for the elective group. Basetine clinical variables were similar for both the myocardial infarction and elective groups except for a higher percentage of men in the infarction group (81 versus 63%, p = 0.001). The number of coronary lesions undergoing angioplasty and the incidence of intimal dissection were similar, but multivessel angioplasty was more common in the elective group (13 versus 4%, p = 0.02). The rate of in-hospital reocclusion was higher in the patients receiving angioplasty for myocardial infarction (13 versus 2%, p = 0.0001). At the time of late follow-up after hospital discharge, the patients with myocardial infarction were more often asymptomatic (79 versus 55%, p = 0.0001), and the rate of angiographic coronary restenosis was lower for the infarction group both overall (19 versus 35%, p = 0.006) and when multivessel angioplasty patients were excluded (19 versus 33%, p = 0.01). These findings indicate that the rate of early reocclusion is higher and that of long-term restenosis is lower after successful emergent coronary angioplasty in the setting of thrombolytic therapy with streptokinase for acute myocardial infarction than after elective angioplasty.

Original languageEnglish (US)
Pages (from-to)698-705
Number of pages8
JournalJournal of the American College of Cardiology
Volume11
Issue number4
DOIs
StatePublished - Apr 1988

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Simonton, C. A., Mark, D. B., Hinohara, T., Rendall, D. S., Phillips, H. R., Peter, R. H., Behar, V. S., Kong, Y., O'Callaghan, W. G., O'Connor, C., Califf, R. M., & Stack, R. S. (1988). Late restenosis after emergent coronary angioplasty for acute myocardial infarction: Comparison with elective coronary angioplasty. Journal of the American College of Cardiology, 11(4), 698-705. https://doi.org/10.1016/0735-1097(88)90198-2