Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: Late is Better Than Not Done at All

Hendrawati Hendrawati (Department of Cardiology and Vascular Medicine, Dr. Haryoto General Hospital, Lumajang, Indonesia. Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia)
Mohammad Saifur Rohman (Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malan)
Cholid Tri Tjahjono (Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.)
Sasmojo Widito (Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.)
Budi Satrijo (Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.)
Yoga Waranugraha (Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.)
Muhammad Rizki Fadlan (Brawijaya Cardiovascular Research Center, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.)

Heart Science Journal
Vol 1, No 3 (2020): Management of Coronary Artery Disease: From Risk Factors to The Better Long-Term

Background : For ST-segment elevation myocardial infarction (STEMI) patients, reperfusion through primary percutaneous coronary intervention (PCI) must be done to return the coronary arteries' blood flow. However, a large proportion of patients received late PCI. This study aimed to assess the impact of late PCI on the clinical outcomes of STEMI patients.Methods : A retrospective cohort study was conducted in Saiful Anwar General Hospital from January 2017 to April 2018. A total of 192 STEMI patients were divided into three groups: (1) on-time PCI; (2) late PCI; and (3) no PCI. The outcome measured included six months and 12 months of cardiovascular mortality and hospital readmission because of worsening heart failure and recurrent myocardial infarction (MI).Results: At six-month follow-up period, we found that hospital readmission was higher in the no PCI group (9.2% vs. 12.1% vs. 34.8%; p = 0.009). The recurrent MI (0% vs. 0% vs. 7.2%; p = 0.010) and worsening heart failure (6.2% vs. 8.6% vs. 33.3%; p < 0.001) was also higher in the no PCI group. On 12 months follow up period, the mortality (4.6% vs. 13.8% vs. 21.7%; p = 0.015) and hospital readmission (15.4% vs. 20.7% vs. 42%; p = 0.001) rate was higher in no PCI group. Hospital readmission because of worsening heart failure was also higher in no PCI group (9.2% vs. 17.2% vs. 37.7%; p = 0.015).Conclusion: Not performing revascularization was correlated with higher mortality and hospital readmission rate in STEMI patients. Late PCI was associated with better outcomes than not conducting revascularization.