Doo Sun Sim1, Myung Ho Jeong2, Youngkeun Ahn1, Young Jo Kim1, Shung Chull Chae1, Taek Jong Hong1, In Whan Seong1, Jei Keon Chae1, Chong Jin Kim1, Myeong Chan Cho1, Seung-Woon Rha1, Jang Ho Bae1, Ki Bae Seung1, Seung Jung Park1. 1. From the Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea (D.S.S., M.H.J., Y.A.); Division of Cardiology, Yeungnam University Hospital, Daegu, Republic of Korea (Y.J.K.); Division of Cardiology, Kyungpuk National University Hospital, Daegu, Republic of Korea (S.C.C.); Department of Cardiology, Busan National University Hospital, Republic of Korea (T.J.H.); Department of Cardiology, Chungnam National University Hospital, Daejon, Republic of Korea (I.W.S.); Department of Cardiology, Chunbuk National University Hospital, Jeonju, Republic of Korea (J.K.C.); Department of Cardiovascular Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea (C.J.K.); Department of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea (M.C.C.); Department of Cardiology, Korea University Guro Hospital, Seoul (S.-W.R.); Division of Cardiology, Konyang University Hospital, Daejon, Republic of Korea (J.H.B.); Division of Cardiology, Catholic University Hospital, Seoul, Republic of Korea (K.B.S.); and Department of Cardiology, Asan Medical Center, Seoul, Republic of Korea (S.J.P.). 2. From the Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea (D.S.S., M.H.J., Y.A.); Division of Cardiology, Yeungnam University Hospital, Daegu, Republic of Korea (Y.J.K.); Division of Cardiology, Kyungpuk National University Hospital, Daegu, Republic of Korea (S.C.C.); Department of Cardiology, Busan National University Hospital, Republic of Korea (T.J.H.); Department of Cardiology, Chungnam National University Hospital, Daejon, Republic of Korea (I.W.S.); Department of Cardiology, Chunbuk National University Hospital, Jeonju, Republic of Korea (J.K.C.); Department of Cardiovascular Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea (C.J.K.); Department of Cardiology, Chungbuk National University Hospital, Cheongju, Republic of Korea (M.C.C.); Department of Cardiology, Korea University Guro Hospital, Seoul (S.-W.R.); Division of Cardiology, Konyang University Hospital, Daejon, Republic of Korea (J.H.B.); Division of Cardiology, Catholic University Hospital, Seoul, Republic of Korea (K.B.S.); and Department of Cardiology, Asan Medical Center, Seoul, Republic of Korea (S.J.P.). myungho@chollian.net.
Abstract
BACKGROUND: The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute ST-elevation or Non-ST-elevation Myocardial Infarction 2015 suggested that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PPCI). We sought to assess the clinical impact of pharmacoinvasive strategy compared with PPCI in real-world patients with ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We used the Korea Acute Myocardial Infarction Registry to identify ST-segment-elevation myocardial infarction patients receiving either pharmacoinvasive strategy defined as fibrinolysis followed by percutaneous coronary intervention (rescue/urgent or routine elective; n=708) or PPCI (n=8878). Patients receiving facilitated percutaneous coronary intervention within 3 hours from fibrinolysis were excluded. Propensity-matched 12-month clinical outcome was compared. In the propensity-matched cohort (n=706 in each group), the pharmacoinvasive group had shorter time to reperfusion therapy (165 versus 241 minutes; P<0.001) and higher rate of pre-percutaneous coronary intervention Thrombolysis in Myocardial Infarction grade 3 (50.4% versus 13.7%; P<0.001). Incidences of major bleeding and stroke during hospitalization were not different. Twelve-month rates of death and major adverse cardiac events (composite of death, recurrent myocardial infarction, target-vessel revascularization, and coronary artery bypass graft surgery) were similar between pharmacoinvasive strategy and PPCI: 4.4% versus 4.1% and 7.5% versus 7.8%, respectively. Equipoise between pharmacoinvasive strategy and PPCI for 12-month major adverse cardiac events occurred when percutaneous coronary intervention-related delay was ≈100 minutes. CONCLUSIONS: ST-segment-elevation myocardial infarction patients receiving pharmacoinvasive treatment, compared with PPCI, had shorter time to reperfusion, higher culprit-vessel patency, and similar 12-month clinical outcome.
BACKGROUND: The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute ST-elevation or Non-ST-elevation Myocardial Infarction 2015 suggested that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PPCI). We sought to assess the clinical impact of pharmacoinvasive strategy compared with PPCI in real-world patients with ST-segment-elevation myocardial infarction. METHODS AND RESULTS: We used the Korea Acute Myocardial Infarction Registry to identify ST-segment-elevation myocardial infarctionpatients receiving either pharmacoinvasive strategy defined as fibrinolysis followed by percutaneous coronary intervention (rescue/urgent or routine elective; n=708) or PPCI (n=8878). Patients receiving facilitated percutaneous coronary intervention within 3 hours from fibrinolysis were excluded. Propensity-matched 12-month clinical outcome was compared. In the propensity-matched cohort (n=706 in each group), the pharmacoinvasive group had shorter time to reperfusion therapy (165 versus 241 minutes; P<0.001) and higher rate of pre-percutaneous coronary intervention Thrombolysis in Myocardial Infarction grade 3 (50.4% versus 13.7%; P<0.001). Incidences of major bleeding and stroke during hospitalization were not different. Twelve-month rates of death and major adverse cardiac events (composite of death, recurrent myocardial infarction, target-vessel revascularization, and coronary artery bypass graft surgery) were similar between pharmacoinvasive strategy and PPCI: 4.4% versus 4.1% and 7.5% versus 7.8%, respectively. Equipoise between pharmacoinvasive strategy and PPCI for 12-month major adverse cardiac events occurred when percutaneous coronary intervention-related delay was ≈100 minutes. CONCLUSIONS: ST-segment-elevation myocardial infarctionpatients receiving pharmacoinvasive treatment, compared with PPCI, had shorter time to reperfusion, higher culprit-vessel patency, and similar 12-month clinical outcome.
Authors: Manuel Chacón-Diaz; Piero Custodio-Sánchez; Paol Rojas De la Cuba; Germán Yábar-Galindo; René Rodríguez-Olivares; David Miranda-Noé; Luis Marcos López-Rojas; Akram Hernández-Vásquez Journal: BMC Cardiovasc Disord Date: 2022-06-29 Impact factor: 2.174
Authors: Diego Araiza-Garaygordobil; Rodrigo Gopar-Nieto; Alejandro Cabello-López; Pablo Martinez-Amezcua; Guering Eid-Lidt; Luis A Baeza-Herrera; Héctor Gonzalez-Pacheco; Jose Luis Briseño-De la Cruz; Daniel Sierra-Lara Martinez; Salvador Mendoza-García; Alfredo Altamirano-Castillo; Alexandra Arias-Mendoza Journal: CJC Open Date: 2020-11-25
Authors: Himawan Fernando; Diem Dinh; Stephen J Duffy; Angela Brennan; Anand Sharma; David Clark; Andrew Ajani; Melanie Freeman; Karlheinz Peter; Dion Stub; Chin Hiew; Christopher M Reid; Ernesto Oqueli Journal: Int J Cardiol Heart Vasc Date: 2021-03-15
Authors: Deep Chandh Raja; Vijayakumar Subban; Suma M Victor; George Joseph; Viji Samuel Thomson; Kumaresan Kannan; Justin Paul Gnanaraj; Ganesh Veerasekar; Jose G Thenpally; Nandhini Livingston; Brahmajee K Nallamothu; Thomas Alexander; Ajit S Mullasari Journal: Indian Heart J Date: 2017-07-18
Authors: Haitham Khraishah; Barrak Alahmad; Eric Secemsky; Michael N Young; Ahmed ElGuindy; Mark J Siedner; Mohamad Kassab; Dhaval Kholte; Khuzeima Khanbhai; Mohamed Janabi; Kevin Kennedy; Mazen S Albaghdadi Journal: Glob Heart Date: 2020-10-12