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Published online: 2021-07-07
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Clinical outcomes in patients with acute myocardial infarction treated with primary percutaneous coronary intervention stratified according to duration of pain-to-balloon time and type of myocardial infarction

Bartłomiej Staszczak, Zbigniew Siudak, Krzysztof Piotr Malinowski, Magdalena Jędrychowska, Michał Zabojszcz, Magdalena Dolecka-Ślusarczyk, Agnieszka Janion-Sadowska, Michał Susuł, Tomasz Tokarek, Joanna Bartuś, Artur Pawlik, Sylwia Socha, Andrzej Surdacki, Stanisław Bartuś, Rafał Januszek
DOI: 10.5603/CJ.a2021.0074
·
Pubmed: 34240403

open access

Ahead of print
Original articles
Published online: 2021-07-07

Abstract

Background: Based on the clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), treated with primary percutaneous coronary intervention (pPCI), this study intended to assess mortality and major adverse cardiac and cerebrovascular event (MACCE) rates according to duration of pain-to-balloon (PTB) time and type of MI.   Methods: This is a retrospective cohort study based on the prospectively collected ORPKI registry which covers PCIs performed in Poland chosen between January 2014 and December 2017. Under assessment were 1,994 STEMI and 923 NSTEMI patients. Study endpoints included mortality and MACCE rates (in-hospital, 30-day, 12- and 36-month). Predictors of all-cause mortality in the overall group, STEMI and NSTEMI were assessed by multivariable analysis. Results: Kaplan-Meier survival curve analysis did not reveal significant differences between the STEMI and NSTEMI group for all-cause mortality or MACCE at the 36-month follow-up. While in the long PTB time group, MACCE rate was significantly greater in STEMI patients when compared to NSTEMI (p = 0.004). Among STEMI patients, the short, medium and long PTB time groups differed significantly in the rate of all-cause mortality (p = 0.006) and MACCE (p = 0.04) at 1,095 days of follow-up, which were the greatest in the long PTB time group. Conclusions: Before considering the length of PTB time, there were no statistically significant differences in mortality or MACCE frequency between the STEMI and NSTEMI group at 36-month follow-up. Longer PTB times are related to significantly greater mortality at the 36-month follow-up in the STEMI, but not in the NSTEMI group.

Abstract

Background: Based on the clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), treated with primary percutaneous coronary intervention (pPCI), this study intended to assess mortality and major adverse cardiac and cerebrovascular event (MACCE) rates according to duration of pain-to-balloon (PTB) time and type of MI.   Methods: This is a retrospective cohort study based on the prospectively collected ORPKI registry which covers PCIs performed in Poland chosen between January 2014 and December 2017. Under assessment were 1,994 STEMI and 923 NSTEMI patients. Study endpoints included mortality and MACCE rates (in-hospital, 30-day, 12- and 36-month). Predictors of all-cause mortality in the overall group, STEMI and NSTEMI were assessed by multivariable analysis. Results: Kaplan-Meier survival curve analysis did not reveal significant differences between the STEMI and NSTEMI group for all-cause mortality or MACCE at the 36-month follow-up. While in the long PTB time group, MACCE rate was significantly greater in STEMI patients when compared to NSTEMI (p = 0.004). Among STEMI patients, the short, medium and long PTB time groups differed significantly in the rate of all-cause mortality (p = 0.006) and MACCE (p = 0.04) at 1,095 days of follow-up, which were the greatest in the long PTB time group. Conclusions: Before considering the length of PTB time, there were no statistically significant differences in mortality or MACCE frequency between the STEMI and NSTEMI group at 36-month follow-up. Longer PTB times are related to significantly greater mortality at the 36-month follow-up in the STEMI, but not in the NSTEMI group.

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Keywords

acute myocardial infarction, clinical outcomes, mortality, pain-to-balloon time, primary percutaneous coronary intervention

About this article
Title

Clinical outcomes in patients with acute myocardial infarction treated with primary percutaneous coronary intervention stratified according to duration of pain-to-balloon time and type of myocardial infarction

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-07-07

DOI

10.5603/CJ.a2021.0074

Pubmed

34240403

Keywords

acute myocardial infarction
clinical outcomes
mortality
pain-to-balloon time
primary percutaneous coronary intervention

Authors

Bartłomiej Staszczak
Zbigniew Siudak
Krzysztof Piotr Malinowski
Magdalena Jędrychowska
Michał Zabojszcz
Magdalena Dolecka-Ślusarczyk
Agnieszka Janion-Sadowska
Michał Susuł
Tomasz Tokarek
Joanna Bartuś
Artur Pawlik
Sylwia Socha
Andrzej Surdacki
Stanisław Bartuś
Rafał Januszek

References (15)
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