The Outcomes of Primary PCI and Importance of Clinical Characteristics of the Patient on Presentation

Authors

  • Sajjad Ullah Khan Lady Reading Hospital, Peshawar, KP, Pakistan
  • Hamid Shahzad Lady Reading Hospital peshawar, KP, Pakistan.
  • Sher Bahadar Khan Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Samra Rahmat Lady Reading Hospital, Peshawar, KP, Pakistan.
  • Imran Khan Lady Reading Hospital, Peshawar, KP, Pakistan.

DOI:

https://doi.org/10.52206/jsmc.2024.14.4.981

Abstract

Background: Acute St-segment elevation myocardial infarction (STEMI) is one of the most important cardiac emergency. Primary percutaneous intervention (PPCI) is the gold standard treatment of STEMI according to the American college of cardiology guidelines.
Objectives: The goal of this research was to determine the In-hospital outcome of primary percutaneous intervention (PPCI) at Lady Reading hospital, Peshawar and its association to the clinical characteristics of the patient on presentation.
Materials and Methods: A total of 90 patients with ST elevation Myocardial infarction (MI) and undergoing PPCI were enrolled in to this prospective observational study conducted in department of Cardiology from 23th March, 2023 to 22nd August, 2023. Enrolled patients were followed during hospital stay to determine major adverse cardiovascular events (MACES), which included outcomes of mortality, recurrent MI, need for repeat revascularization, Acute renal failure (ARF), angina, CVA, acute LVF, Cardiogenic shock and stent thrombosis.
Results: The most common adverse event was acute LVF (11.1%) followed by cardiogenic shock (7.8%) and angina (6.7%) Furthermore, logistic regression analysis results showed a strong relationship between pulse rate recorded on presentation and MACE outcomes.
Conclusion: Low rates of re-procedures and mortality during hospitalization were found, Ensuring the safety and efficacy of PPCI; higher pulse rates may be associated with a higher risk of unfavorable outcomes.
Keywords: Coronary lesion, MACE, PPCI, STEMI.

References

Minhas AMK, Sedhom R, D Jean E, D Shapiro M. Global burden of cardiovascular disease attributable to smoking, 19902019: an analysis of the 2019 Global Burden of Disease Study, European Journal of Preventive Cardiology, Volume 31, Issue 9, July 2024, 1123-1131. DOI: https://doi.org/10.1093/eurjpc/zwae040

Roth GA, Mensah GA, Fuster V. The Global Burden of Cardiovascular Diseases and Risks: A Compass for Global Action. J Am Coll Cardiol. 2020 Dec 22;76(25):2980-2981. PMID: 33309174. DOI: https://doi.org/10.1016/j.jacc.2020.11.021

Arafa A, Lee H-H, Eshak ES, Shirai K, Liu K, Li J, et al. Modifiable Risk Factors for Cardiovascular Disease in Korea and Japan. kcj. 2021;51(8):643- 55. DOI: https://doi.org/10.4070/kcj.2021.0121

Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(3):e4-e17. DOI: http://10.1161/CIR.0000000000001061 PMID: 34882436.

Nishio R, Ogita M, Suwa S, Nakao K, Ozaki Y, Kimura K, et al. Shorter door-to-balloon time, better long-term clinical outcomes in ST-segment elevation myocardial infarction patients: J-MINUET substudy. Journal of Cardiology. 2023;81(6):564-70. DOI: https://doi.org/10.1016/j.jjcc.2023.01.008

Arispe, INSR, Sol J, Gil AC. Comparison of heart, grace and TIMI scores to predict major adverse cardiac events from chest pain in a Spanish health care region. Sci Rep 13, 2023.172-80. DOI: https://doi.org/10.1038/s41598-023-44214-3

Vroegindewey MM, Schuurman A-S, Oemrawsingh RM, van Geuns R-J, Kardys I, Ligthart J, et al. SYNTAX score II predicts long-term mortality in patients with one-or two-vessel disease. PloS one. 2018;13(7):e0200076. DOI: https://doi.org/10.1371/journal.pone.0200076

Baptista SB, Farto e Abreu P, Loureiro JR, Thomas B, Nédio M, Gago S, et al. PAMI risk score for mortality prediction in acute myocardial indarction treated with primary angioplasty. Rev Port Cardiol. 2004;23(5):683-93. 2004 May;23(5):683-693 PMID: 15279453.

Choudhary S. Association of syntax score with short-term outcomes among acute ST-elevation myocardial infarction patients undergoing primary PCI. Indian Heart J. 2017 Apr;69 Suppl 1(Suppl 1):S20-S23. Epub 2016 Aug 24. PMID: 28400034; PMCID: PMC5388013. DOI: https://doi.org/10.1016/j.ihj.2016.08.002

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD; Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction; Katus HA, Lindahl B, Morrow DA, Clemmensen PM, Johanson P, et.al. Third universal definition of myocardial infarction. Circulation. 2012 Oct 16;126(16):2020- 35. Epub 2012 Aug 24. PMID: 22923432. DOI: https://doi.org/10.1161/CIR.0b013e31826e1058

Bouisset F, Gerbaud E, Bataille V. Percutaneous Myocardial Revascularization in Late-Presenting Patients With STEMI. JACC. 2021 Sep, 78 (13) 1291-1305. DOI: https://doi.org/10.1016/j.jacc.2021.07.039

Uwe Zeymer, Hector Bueno, Christopher B Granger, Judith Hochman et al. Acute Cardiovascular Care Association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: A document of the Acute Cardiovascular Care Association of the European Society of Cardiology, European Heart Journal. Acute Cardiovascular Care, Volume 9, Issue 2, 1 March 2020, 183-197. DOI: https://doi.org/10.1177/2048872619894254

Klein LW, Nathan S, Maehara A, Messenger J, Mintz GS, Ali ZA, et al. SCAI Expert Consensus Statement on Management of In-Stent Restenosis and Stent Thrombosis. Journal of the Society for Cardiovascular Angiography & Interventions. 2023;2(4). DOI: https://doi.org/10.1016/j.jscai. 2023.100971

Solangi BA, Shah JA, Kumar R, Batra MK, Ali G. Immediate in-hospital outcomes after percutaneous revascularization of acute myocardial infarction complicated by cardiogenic shock. World J Cardiol. 2023 Sep 26;15(9):439-447. DOI: https://doi.org/10.4330/wjc.v15.i9.439 PMID: 37900262; PMCID: PMC10600783.

Mo C, Huang Q, Li L. High-mobility group box 1 and its related receptors: potential therapeutic targets for contrast-induced acute kidney injury. Int Urol Nephrol 56,2024. 2291-2299. DOI: https://doi.org/10.1007/s11255-024-03981-2

Price AL, Amin AP, Rogers S, Messenger JC, Moussa ID, Miller JM, et al. Implementation of a Multidimensional Strategy to Reduce Post-PCI Bleeding Risk. Circulation: Cardiovascular Interventions. 2024;17(3):e013003. DOI: https://doi.org/10.1161/CIRCINTERVENTIONS.123.013003

Akhtar Z, Aleem MA, Ghosh PK. In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh. BMC Cardiovasc Disord 2021, 85. DOI: https://doi.org/10.1186/s12872-021-01896-9

Kim D-Y, Wala Z, Islam S, Islam R, Ahn M. Clinical characteristics and outcomes of ST-segment elevation myocardial infarction in a low income setting in rural Bangladesh. IJC Heart & Vasculature. 2019;23:1003-76. DOI: https://doi.org/10.1016/j.ijcha.2019.100376

Vos NS, Amoroso G, Vink MA, Maarse M, Adams R, Herrman J, et al. Prehospital Prasugrel Versus Ticagrelor in Real-World Patients With ST-Elevation Myocardial Infarction Referred for Primary PCI: Procedural and 30-Day Outcomes. The Journal of Invasive Cardiology. 2018;30(12):431-6.PMID: 30318484.

Umapathy S, Yadav R, Goswami KC, Karthikeyan G, Parakh N. Prognostic significance of fragmented QRS in patients with ST-elevation myocardial infarction undergoing revascularization. Indian Heart Journal. 2018;70:S126-S32. DOI: https://doi.org/10.1016/j.ihj.2018.07.014

Berwanger O, Santucci EV, de Barros e Silva PGM. Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial. JAMA. 2018;319(13):1331-1340. DOI: https://doi.org/10.1001/jama.2018.2444

Liu R, Liu J, Yang J, Gao Z, Zhao X, Chen J, et al. Association of thrombocytopenia with in-hospital outcome in patients with acute ST-segment elevated myocardial infarction. Platelets. 2019;30(7):844-53. DOI: https://doi.org/10.1080/09537104.2018.1529298

Sun Y, Feng L, Li X, Gao R, Wu Y. The sex difference in 6-month MACEs and its explaining variables in acute myocardial infarction survivors: Data from CPACS-3 study. International Journal of Cardiology. 2020;311:1-6. DOI: https://doi.org/10.1016/j.ijcard.2020.03.043

Additional Files

Published

11-11-2024

How to Cite

1.
Sajjad Ullah Khan, Hamid Shahzad, Sher Bahadar Khan, Samra Rahmat, Imran Khan. The Outcomes of Primary PCI and Importance of Clinical Characteristics of the Patient on Presentation. J Saidu Med Coll Swat [Internet]. 2024 Nov. 11 [cited 2024 Dec. 5];14(4):359-66. Available from: http://jsmc.pk/index.php/jsmc/article/view/981