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. 2019 Jun 12;11(2):e011201.
doi: 10.1136/heartasia-2019-011201. eCollection 2019.

Cardiovascular outcomes of early versus delayed coronary intervention in low to intermediate-risk patients with STEMI in Thailand: a randomised trial

Yotsawee Chotechuang  1   2 , Arintaya Phrommintikul  3 , Srun Kuanprasert  3 , Roungtiva Muenpa  4 , Jayanton Patumanond  5 , Tuanchai Chaichuen  6 , Apichard Sukonthasarn  3
Affiliations

Cardiovascular outcomes of early versus delayed coronary intervention in low to intermediate-risk patients with STEMI in Thailand: a randomised trial

Yotsawee Chotechuang et al. Heart Asia. .

Abstract

Background: The benefit of an early coronary intervention after streptokinase (SK) therapy in low to intermediate-risk patients with ST-elevation myocardial infarction (STEMI) still remains uncertain. The current study aimed to evaluate the cardiovascular outcomes of early versus delayed coronary intervention in low to intermediate-risk patients with STEMI after successful therapy with SK.

Methods: We randomly assigned low to intermediate Global Registry of Acute Coronary Events risk score to patients with STEMI who had successful treatment with full-dose SK at Lampang Hospital and Maharaj Nakorn Chiang Mai Hospital into early and delayed coronary intervention groups. The primary endpoints were 30-day and 6-month composite cardiovascular outcomes (death, rehospitalised with acute coronary syndrome, rehospitalised with heart failure and stroke).

Results: One hundred and sixty-two patients were included in our study. At the 30 days, composite cardiovascular outcomes were 4.9% in the early coronary intervention group and 2.5% in the delayed group (p=0.682). At the 6 months, the composite cardiovascular outcomes were 16.1% in the early group and 6.2% in the delayed group (p=0.054).

Conclusions: The delayed coronary intervention (>24 hours) in low to intermediate STEMI after successful therapy with SK did not increase in short and long-term cardiovascular events compared with an early coronary intervention.

Trial registration number: NCT02131103.

Keywords: ST-elevation myocardial infarction; delayed coronary intervention; early coronary intervention; low to intermediate GRACE risk score; successful streptokinase therapy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study flow diagram. CAG, coronary angiography; PCI, percutaneous coronary intervention.
Figure 2
Figure 2
Kaplan-Meier curve of 6-month composite cardiovascular outcomes.
See this image and copyright information in PMC

References

    1. Srimahachota S, Boonyaratavej S, Kanjanavanit R, et al. . Thai Registry in Acute Coronary Syndrome (TRACS)--an extension of Thai Acute Coronary Syndrome registry (TACS) group: lower in-hospital but still high mortality at one-year. J Med Assoc Thai 2012;95:508–18. - PubMed
    1. Borgia F, Goodman SG, Halvorsen S, et al. . Early routine percutaneous coronary intervention after fibrinolysis vs. standard therapy in ST-segment elevation myocardial infarction: a meta-analysis. Eur Heart J 2010;31:2156–69. 10.1093/eurheartj/ehq204 - DOI - PubMed
    1. D'Souza SP, Mamas MA, Fraser DG, et al. . Routine early coronary angioplasty versus ischaemia-guided angioplasty after thrombolysis in acute ST-elevation myocardial infarction: a meta-analysis. Eur Heart J 2011;32:972–82. 10.1093/eurheartj/ehq398 - DOI - PubMed
    1. Wijns W, Kolh P, Danchin N, et al. . Guidelines on myocardial revascularization. the task Force on myocardial revascularization of the European Society of cardiology (ESC) and the European association for Cardio-Thoracic surgery (EACTS). developed with the special contribution of the European association for percutaneous cardiovascular interventions (EAPCI). Eur Heart J 2010;31:2501–55. - PubMed
    1. Steg PG, James SK, Atar D, et al. . ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569–619. 10.1093/eurheartj/ehs215 - DOI - PubMed

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