Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 29;22(1):296.
doi: 10.1186/s12872-022-02730-6.

Outcomes in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention or pharmacoinvasive strategy in a Latin American country

Manuel Chacón-Diaz  1   2 , Piero Custodio-Sánchez  3 , Paol Rojas De la Cuba  4 , Germán Yábar-Galindo  4 , René Rodríguez-Olivares  1 , David Miranda-Noé  1 , Luis Marcos López-Rojas  5 , Akram Hernández-Vásquez  6
Affiliations

Outcomes in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention or pharmacoinvasive strategy in a Latin American country

Manuel Chacón-Diaz et al. BMC Cardiovasc Disord. .

Abstract

Objective: The primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for ST-segment elevation myocardial infarction (STEMI). The pharmacoinvasive strategy (PIs) is a reasonable alternative when prompt PPCI is not possible, especially in resource-limited regions. We aimed to compare PPCI versus PIs outcomes in Peru.

Methods: This was a retrospective cohort study based on the second Peruvian Registry of STEMI (PERSTEMI II). We compared the characteristics, in-hospital outcomes and 30-day mortality of patients undergoing PPCI during the first 12 h and those receiving a PIs. A propensity score-matched analysis was conducted to compare the effects of each treatment strategy on clinical outcomes.

Results: PIs patients were younger than PPCI patients, had a shorter first medical contact time, first medical contact to reperfusion time, and total ischemic time until reperfusion. Successful PCI was more frequent in the PIs group (84.4% vs. 71.1%, p = 0.035). There were no differences between PIs and PPCI in terms of total in-hospital mortality (5.2% vs. 6.6%, p = 0.703), cardiovascular mortality (4.2% vs. 5.3%, p = 0.735), cardiogenic shock (8.3% vs. 13.2%, p = 0.326), heart failure (19.8% vs. 30.3%, p = 0.112), or major bleeding (0% vs. 2.6%, p = 0.194). In the propensity score-matched analysis, the rates of cardiovascular mortality, postinfarction heart failure and successful reperfusion were similar.

Conclusions: In this real-world study, no differences were found in the in-hospital outcomes between patients with STEMI who received PIs or PPCI.

Keywords: Heart failure; Mortality; Myocardial infarction; Peru; Reperfusion.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart representing participant selection according to reperfusion strategies in the PERSTEMI II registry. PPCI primary percutaneous coronary intervention, PI pharmacoinvasive strategy
Fig. 2
Fig. 2
Time delays until the first medical contact and reperfusion according to the study groups. IQR interquartile range
Fig. 3
Fig. 3
Kaplan–Meier survival rate by reperfusion strategy
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Araiza-Garaygordobil D, Gopar-Nieto R, Cabello-López A, Martinez-Amezcua P, Eid-Lidt G, Baeza-Herrera LA, et al. Pharmacoinvasive strategy vs primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction: results from a study in Mexico city. CJC Open. 2020;3(4):409–418. doi: 10.1016/j.cjco.2020.11.012. - DOI - PMC - PubMed
    1. Ibánez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Rev Esp Cardiol (Engl Ed) 2017;70(12):1082. doi: 10.1016/j.rec.2017.11.010. - DOI - PubMed
    1. Bainey KR, Armstrong PW, Zheng Y, Brass N, Tyrrell BD, Leung R, et al. Pharmacoinvasive strategy versus primary percutaneous coronary intervention in ST-elevation myocardial infarction in clinical practice: insights from the Vital Heart Response Registry. Circ Cardiovasc Interv. 2019;12(10):e008059. doi: 10.1161/CIRCINTERVENTIONS.119.008059. - DOI - PubMed
    1. Armstrong PW, Gershlick AH, Goldstein P, Wilcox R, Danays T, Lambert Y, et al. Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction. N Engl J Med. 2013;368(15):1379–1387. doi: 10.1056/NEJMoa1301092. - DOI - PubMed
    1. Sim DS, Jeong MH, Ahn Y, Kim YJ, Chae SC, Hong TJ, et al. Pharmacoinvasive strategy versus primary percutaneous coronary intervention in patients with ST-segment-elevation myocardial infarction: a propensity score-matched analysis. Circ Cardiovasc Interv. 2016;9(9):e003508. doi: 10.1161/CIRCINTERVENTIONS.115.003508. - DOI - PubMed

MeSH terms

Substances