Very late clinical progression of patients with acute myocardial infarction submitted to primary angioplasty

Abstract

Background: Information on the clinical progression, in the long term, of patients submitted to mechanical reperfusion is scarce.

Objective: The objective of this study is to describe the long-term clinical progression of patients submitted to primary stenting.

Methods: Between January 1998 and December 2003 we studied a non-concurring cohort with a fixed population of 202 patients (mean age = 61.2 +/- 7.7 years; 74.7% males and 25.3% females) submitted to primary stenting. All the patients were followed up clinically and we assessed the occurrence of deaths, acute myocardial infarction (AMI), cerebral vascular accident (CVA) and surgical or percutaneous myocardial revascularization (MR). Kaplan-Meier survival curves were built for the following events: death, deaths/AMI, deaths/AMI/CVA and major cardiovascular events (MCE).

Results: In 91.5% of the patients the procedure was successful. During hospital stay, mortality was 3.4%; reinfarction was 0.9%; CVA was 1.8%; and urgent MR was 1.4%. Clinical follow-up varied from 29 to 100 months (mean = 58.7 +/- 19.7 months). Death-free survival was estimated at 93.6%; death/AMI-free survival at 89.6%; death-AMI/CVA-free survival at 87.1%; and MCE-free survival at 71.3%

Conclusion: Primary stenting presented excellent results during hospital stay. Very late clinical follow-up demonstrated that these good initial results have held up.