Long-Term Outcomes with Selective Drug Eluting Stent Use in ST-Elevation Myocardial Infarction in an Australian Urban Population

Abstract

Methods: All coronary angiograms are reported via a computerised database. A retrospective search was performed over the last six years by using keyword free text search. When a case was identified, the files, angiograms, ECGs and echocardiograms were reviewed. Results: Six cases in 5800 patients were identified resulting in a reported incidence of 0.1%. All were elderly females (67-88, mean 77.7 years). All had a history of hypertension and five of six had LV hypertrophy documented on echocardiography. Despite varied indications for angiography including ischaemic chest pain, NSTEMI and heart failure with troponin elevation no patients had flow limiting disease. A typical angiographic pattern of minor non-obstructive disease with tortuous vessels was seen in all patients. Conclusion: Although possibly under reported, Thebesian drainage was rare (0.1%) in our series. Striking similarities existed in all patients (elderly hypertensive females with non obstructive disease in tortuous vessels). This data suggests that these patients represent a distinct clinical syndrome. Whether this is genetic or acquired remains unclear but warrants further investigation.