Frequency and outcome of chest pain after two new coronary interventions (atherectomy and stenting)

摘要: Between June 1988 and July 1991, 464 new device interventions (Palmaz-Schatz stent or Simpson directional atherectomy) were performed in 410 patients. Chest pain occurred within 72 hours after the procedure 94 patients (23%). All evaluated with electrocardiograms cardiac isoenzymes on day procedure, urgent repeat coronary angiography was 29 chest (31%). Whereas all 14 abnormal findings had electrocardiographic changes, 6 of 20 restudied (30%) changes no angiographic explanation for pain. Non-Q-wave myocardial infarction 22 (5%) (10 35 [29%] 3 44 [7%] change, 9 316 [3%] without pain). Factors associated intervention included a decreased residual percent stenosis (p = 0.05), incomplete revascularization 0.005) presence multivessel disease 0.001). Vessel dissection stenting but not atherectomy postprocedure is common (23%) intervention. Electrocardiographic are sensitive marker abnormality confer higher risk non-Q-wave infarction, increase in-hospital mortality. Determinants lower stenosis, disease. Patients early successful placement need routinely undergo recatheterization.