What question did this study set out to answer?

This research aims to evaluate how early percutaneous coronary intervention affects long-term survival rates in patients who have had an acute myocardial infarction.

January 10, 2026Cureus0 citationsOpen Access

Impact of Early Percutaneous Coronary Intervention on Long-Term Survival in Patients With Acute Myocardial Infarction

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute Myocardial Infarction (n=891). Intervention: Early Percutaneous Coronary Intervention (PCI) vs. Delayed or No PCI. Primary outcome: Long-term all-cause mortality (HR 0.54, 95% CI 0.40-0.73, p=<0.001).

KRKhurrum Rashid UQUzair Ullah Qureshi HRHafiz Ali Shabbir Rajput

Key Result

Early PCI is associated with significant reductions in all-cause mortality and other adverse outcomes in patients with acute myocardial infarction.

Key Points

This research aims to evaluate how early percutaneous coronary intervention affects long-term survival rates in patients who have had an acute myocardial infarction.
Retrospective observational study design
Analysis of patient records with acute myocardial infarction
Comparison of outcomes based on timing of intervention
Statistical analysis of survival rates
Patients receiving early intervention had significantly higher survival rates at 5 years
Reduction in mortality risk was observed in the early intervention group
Long-term cardiovascular outcomes were better in the early treatment group

Study Design

Type

Cohort (n=891)

Multicenter

Structured PICO

Does early percutaneous coronary intervention (≤24 hours) improve long-term survival in adult patients with acute myocardial infarction compared to delayed or no PCI?

Population

891 adult patients (≥18 years) with a primary diagnosis of acute myocardial infarction (AMI) admitted to a tertiary care hospital in Pakistan. Key exclusions: type 2 MI, transfer since previous PCI, emergent CABG prior to PCI, terminal non-cardiac sickness with life expectancy <6 months.

Intervention

Early percutaneous coronary intervention (PCI), defined as intervention performed within 24 hours of hospital arrival.

Comparator

Delayed PCI (performed >24 hours after hospital arrival during the index hospitalization) or no PCI during the index hospitalization.

Outcome

Long-term all-cause mortality, calculated from the time of hospital admission to death or last known follow-up at median 48 months.hard clinical

Early percutaneous coronary intervention (≤24 hours) in patients with acute myocardial infarction is associated with a significant reduction in long-term all-cause and cardiovascular mortality compared to delayed or no PCI.

Main Result

Effect estimate: HR 0.54 (95% CI 0.40-0.73)

Absolute Event Rate: 13.9% vs 25.2%

p-value: p=<0.001

Limitations

Residual confounding may remain despite propensity score matching
Single-center design may limit generalizability
Variability in documentation may affect data accuracy

Abstract

BACKGROUND: Early percutaneous coronary intervention (PCI) is the recommended standard of care for acute myocardial infarction (AMI), but long-term outcomes in mixed real-world cohorts remain underreported. This study evaluated the effects of early PCI (≤24 hours) compared with delayed or no PCI on short- and long-term clinical outcomes. MATERIALS AND METHODS: A five-year mixed cohort study was conducted and included 891 consecutive AMI patients (early PCI, n = 446; delayed/no PCI, n = 445). Demographics, clinical characteristics, procedural data, and in-hospital outcomes were collected. Long-term outcomes, such as all-cause mortality, cardiovascular mortality, recurrent myocardial infarction (MI), heart failure (HF) hospitalization, and major adverse cardiovascular events (MACE), were assessed over a median follow-up of 48 months. Propensity score matching and Cox proportional hazards models were used to adjust for confounding. Statistical analyses were done in the IBM SPSS Statistics software, version 27.0 (IBM Corp., Armonk, NY, USA). Results: Early PCI was associated with lower in-hospital mortality (18/446, 4.0% vs 35/445, 7.9%; p = 0.01), shorter door-to-balloon time (median 65 vs 210 minutes; p < 0.001), and better left ventricular function (mean left ventricular ejection fraction (LVEF) 48.7% vs 46.2%; p < 0.001). Over a median follow-up of 48 months, early PCI significantly reduced all-cause mortality (62/446, 13.9% vs 112/445, 25.2%; adjusted hazard ratio (HR) 0.54, 95% CI 0.40-0.73, p < 0.001), cardiovascular mortality (44/446, 9.9% vs 82/445, 18.4%; adjusted HR 0.53, 95% CI 0.37-0.77, p = 0.001), HF hospitalization (56/446, 12.6% vs 84/445, 18.9%; adjusted HR 0.66, 95% CI 0.47-0.93, p = 0.02), and MACE (92/446, 20.6% vs 138/445, 31.0%; adjusted HR 0.63, 95% CI 0.49-0.82, p < 0.001). Recurrent MI was slightly lower with early PCI (38/446, 8.5% vs 49/445, 11.0%; adjusted HR 0.78, 95% CI 0.52-1.16, p = 0.21) but did not reach statistical significance. CONCLUSION: Early PCI confers substantial short- and long-term survival benefits in AMI patients, with significant reductions in all-cause and cardiovascular mortality, HF hospitalization, and MACE. These findings underscore the critical importance of timely reperfusion, supporting guideline-driven early PCI strategies in real-world practice.

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Cite This Study

Rashid et al. (Fri,) conducted a cohort in Acute Myocardial Infarction (n=891). Early Percutaneous Coronary Intervention (PCI) vs. Delayed or No PCI was evaluated on Long-term all-cause mortality (HR 0.54, 95% CI 0.40-0.73, p=<0.001). Early PCI is associated with significant reductions in all-cause mortality and other adverse outcomes in patients with acute myocardial infarction.

synapsesocial.com/papers/696321b391e05aa366cb7ecd https://doi.org/https://doi.org/10.7759/cureus.101145

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