The only thing constant in interventional cardiology is change. A short time ago the idea of implanting coronary stents in infarctrelated arteries was viewed as radical, but a growing experience suggests otherwise. Berland et al. now provide us the first analysis of the 1-yr outcome of patients treated with stents during an evolving myocardial infarction.
Patients treated with balloon angioplasty during acute myocardial infarction run the risk of restenosis and repeat intervention. O'Keefe et al. reported that 24% of patients required repeat angioplasty over a mean follow-up of 33 mo. Brodie et al. reported a need for repeat angioplasty in 16% of patients within 6 mo of primary infarct angioplasty. The experience of Berland et al.
[1] may compare favorably with these numbers, as only 11% of stented patients required repeat balloon angioplasty during 1 yr of follow-up. A full 72% of patients were completely event-free following infarct artery stenting .
Randomized studies are underway to provide additional information on the routine use of contemporary stent implantation during acute myocardial infarction. The results will be interesting, as the study patients reported by Berland et al. were potentially biased