Key result
STEMI patients undergoing primary PCI at US hospitals had higher rates of adverse events compared to those at non-US hospitals, even after adjusting for baseline risk.
Why the study?
Does primary PCI at US hospitals compared to non-US hospitals affect adverse event rates in STEMI patients?
Does primary PCI at US hospitals compared to non-US hospitals affect adverse event rates in STEMI patients?
STEMI patients treated with primary PCI at US hospitals experienced higher three-year adverse event rates compared to those at non-US hospitals, even after risk adjustment.
US STEMI PCI was associated with higher adverse events; hypothesis-generating and should not yet change practice.
In the HORIZONS-AMI trial, STEMI patients undergoing primary PCI at US versus OUS sites had higher rates of adverse events, which persisted after adjusting for baseline risk. The reasons for these differences are not clear but may be due to unmeasured confounders, different thresholds for event reporting, or valid differences in systems of care and treatments.
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Tobbia et al. (2013) studied this question. STEMI patients undergoing primary PCI at US hospitals had higher rates of adverse events compared to those at non-US hospitals, even after adjusting for baseline risk.
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