C-14 | Impact of timing of Percutaneous Coronary Intervention on outcomes of Acute Myocardial Infarction

Cardiovascular disease is the leading cause of death; the importance of early PCI has been heavily emphasized in acute ST elevation MI but there is often a delay in PCI if there are no ST elevations on EKG. We aim to compare the difference in outcomes of early (≤1 day) vs late (>1 day) PCI in acute myocardial infarction (MI) as a whole. The national readmission database (2016-2020) was queried to identify hospitalizations for acute MI. Cohorts were stratified based on the timing of PCI. A Propensity Score Matching (PSM) model matched patients receiving early vs late PCI. Pearson's x 2 test was applied to PSM-2 matched cohorts to compare outcomes. Among 1 million hospitalizations for acute MI; 342,751 (33.2%) patients had late PCI. After propensity matching (N=238,535), Late PCI was found to be associated with higher mortality (17.9% vs 11.2%, aOR: 2.8), stroke (4.5% vs 2.7%; aOR: 2.51), sudden cardiac arrest (8.3% vs 7.8%, aOR: 1.44), pericardial complications (aOR:1.35), acute kidney injury (AKI) (31.5% vs 27.9%, aOR:1.6) & major adverse cardiac events (MACE) (23.7% vs 17.6%, aOR: 2.2) [p<0.001]. From 2016-2020; mortality associated with late PCI has not changed significantly (∼17.2%) and has remained much higher than mortality with early PCI (∼7.9%) [p<0.05]. On the other hand, early PCI was found to be associated with higher readmission rates 30-day (14.4% vs 9.5%), 90-day (21.3% vs 13.1%) & 180-day (26.5% vs 15.1%) intervals [p<0.001]. In acute MI, late PCI is found to be associated with higher mortality & adverse events. Mortality has not changed significantly across the years for late PCI & remains much higher than early PCI.