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

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概要

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• The objective of the present prospective multicenter case-control study was to investigate the long-term clinical outcome (5years) 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 ≥ 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.

• インターナショナル・ハート・ジャーナル刊行会の論文

著者

• Tsuchihashi Kazufumi

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Shimamoto Kazuaki

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Shimamoto Kazuaki

  札幌医科大学 医学部内科学第二

• Tsuchihashi Kazufumi

  Second Department Of Internal Medicine Sapporo Medical University School Of Medicine

• Noda Ryosuke

  Muroran City General Hospital

• Nagao Kazuhiko

  Sapporo Cardiovascular Hospital

• MURAKAMI Hideyuki

  Second Department of Internal Medicine, Sapporo Medical University School of Medicine

• Sasao Hisataka

  Sapporo Social Insurance General Hospital

• Miyamoto Kenjiro

  Teine Keijinkai Hospital

• Doi Atsushi

  Muroran Shinnittetsu General Hospital

• Shimoshige Shinya

  Kushiro City General Hospital

• Hasegawa Koichi

  Hakodate Goryoukaku Hospital

• Kyuma Michifumi

  Muroran City General Hospital

• Murakami Hideyuki

  Second Department Of Internal Medicine Sapporo Medical University School Of Medicine

• Shimamoto Kazuaki

  Second Department Of Internal Medicine (cardiovascular Medicine) Sapporo Medical University School O

• Nagao Kazuhiko

  Sapporo Cardiovascular Clinic

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