1. Long-Term Outcome After Primary Stenting Versus Balloon Angioplasty for Acute Myocardial Infarction Five-year Follow-up of a Case-control Study
- Author
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Koichi Hasegawa, Hideyuki Murakami, Hisataka Sasao, Ryosuke Noda, Kazuhiko Nagao, Kenjiro Miyamoto, Kazuaki Shimamoto, Michifumi Kyuma, Kazufumi Tsuchihashi, Shinya Shimoshige, and Atsushi Doi
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Stent ,General Medicine ,Odds ratio ,medicine.disease ,Surgery ,Clinical trial ,surgical procedures, operative ,Internal medicine ,Angioplasty ,Heart failure ,medicine ,Clinical endpoint ,Cardiology ,cardiovascular diseases ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,Prospective cohort study ,business - Abstract
The objective of the present prospective multicenter case-control study was to investigate the long-term clinical outcome (5 years) of primary stenting compared to primary percutaneous transluminal coronary angioplasty (PTCA) without stenting (POBA) in patients with acute myocardial infarction at 7 cardiovascular centers in Hokkaido, Japan. Forty-one patients with acute myocardial infarction treated with successful primary stenting (stent group: case) and paired with 41 matched control subjects with acute myocardial infarction treated by successful primary PTCA without stenting (POBA group: control) were analyzed. After 1 year, the stent group had a lower incidence of the combined clinical endpoint (death, rehospitalization due to congestive heart failure, nonfatal myocardial infarction, repeat angioplasty, CABG, or cerebrovascular events) compared to the POBA group (17.1% versus 39.0%, P = 0.049). After 5 years, the incidences of congestive heart failure and cardiac death were the same in both groups. However, compared to the POBA group, the stent group had a lower combined clinical endpoint (34.1% versus 61.0%, P = 0.027). The Kaplan-Meier event-free survival curves of the stent group showed a significantly lower occurrence of clinical events compared to the POBA group (P = 0.0116). Multiple logistic regression analysis of clinical events identified age > or = 69 years (P = 0.0092, odds ratio = 4.179) and stenting (P = 0.0158, odds ratio = 0.279) as explanatory factors. Compared with POBA, primary stenting for acute myocardial infarction results in a better long-term clinical outcome.
- Published
- 2006