saw Vol. 17. No. 2 ehruary !991:99A

ul Vbarra. nise Janosi

St. Louis,

Terry Greenwalt,

pts for a&factual measurements, showed:

Alth SC.

%I: 0 CSA, igher

pred nical using leads VIVSAVF can be used witb good validity [G <*:z-! signal-averaged LP and simultaneously detect cardiac arrhythmias and ST segment changes.

THE IMMEDIATE RESULTS OF NARY ANGIOPLASN FOR ACUTE MYOCARDIAL INFARCTION D FROM THOSE FOR ANGINA PECTORIS: A REPORT FROM THE NHLBI PTCA REGISTRY

Ann Lu Holubkov. Katbenne WI. Deue, David R Holmes, pencer B. Kmg. III. and stry Invesugators.

Rhode Wand Hospital and Brown University Island

To evaluate the utility and role of balloon comnary (ITS) with acute myocardial infarction (AMI). characteristics and outcomes of 294 consecutive IT’S who had an initial CA for AM were FTS wherein CA was performed for either angina pect (NON AMI). AMI and NON AMI PTS did not differ in terms of gender, mul:rksel disease, history of diabetes or hypertension. More @<.oOI) AMI PTS were older. had left ventricular ejection fractions 40% prior unstable angma, and history of heart failure, total coronary occlusion and intmcomnary thrombus. CA outcome differed:

AMI NON AM P n = 294 n = 1.802

(W (W

Angiographic Success Clinical Success

Nonfatal MI Emergency CABG Dissectron In Lab Reocclusion Out of Lab Beocclusion Prolonged Angina

88.1 71.6

5.1

:::

ii:; 7.1 7.5

82.2 a.05 78.2 NS

0.9 401 4.4 NS 3.5 NS 4.8 e.01 4.9 4.01

2.2 <.OOl 4.1 6.05

Stuart J Bresee, Mice K Jacobs, Ann Steenkiste, Seth B bEeaa~iaw, Nicholas A uocco Jr, Katherine i-4 Deere,

MC variabks,

1) was associ- ilV4 was mot. A

is associated associations

rocedural success.

We sought to determine the late

n=294 n = 1,802 (%I (%I

30d 3yr A 3Od 4.8 13.7 8.9 1.1 ‘,$ 4:

uent MI 6.2 12.4 6.2 11:o Ii8

ii:: 15.8 14.7

i-i

CABG 15.5 7.2 &I ::*56 22*7

g-$g~ Failure :: 39.5 16.6 -- -- -- -- 20:o 31.2

9.8

-- --

Late death was observed more commonly during three years of follow- UD in AM? PFS. Reoear RCA. however, was less common in this $oup. Univariate &alysis identified AM as a predictor of death and clinical failure (death, reinfarction, CA% or unimproved symptoms) at

Despite having more advanced and complex cardiac disease, AMI PTS experience initial CA angiographic success more often than NON AMI PTS. Complications. however, are more common among AMl PTS . PTS are less likely to develop coronary dissection than NON AMl PTS but are nearly three times apt to have abrupt reclosure, possibly related to intracoronary thrombus. Thus the results of CA for Ah4I are different than for NON AMI PTS and am probably strongly influenced by characteristics unique to AMI pathophysiology.