The effect of delayed PTCA and stenting on chronic phase of left ventricular remodelling and cardiac events in patients with acute myocardial infarction

Objective To investigate the effect of delayed PTCA and stenting for infarct related artery on the chronic phase of left ventricular remodelling and cardiac events in patients with acute myocardial infarction. Methods Fifty two patients with primary acute myocardial infarction were divided into PTCA group ( n =27) and non PTCA group ( n =25). Twenty seven patients underwent PTCA and coronary stenting with an average of 12 days after the acute onset. Left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) and cardiac events in each group were followed up. Results There were no significant differences in preoperation and postoperation for LVEDV and LVESV in the PTCA group, on the contrary a significant increase for before and after follow up for LVEDV and LVESV in the non PTCA group( P 0.05). No difference for LVEF was found in the two groups. Heart failure (4% vs 44%, P 0.01) and composite events (33% vs 72%, P 0.01) were decreased more significantly in the PTCA group than in the non PTCA group, but there were no significant difference in unstable angina, reinfarct and death of the two groups ( P 0.05). Conclusions Delayed PTCA and stenting for infarct related artery would inhibit ventricular enlargement and delay chronic phase of left ventricular remolding. Moreover, cardiac events were significantly reduced in patients with acute myocardial infarction after delayed PTCA and stenting.