Why the study?
Treatment delay is an important predictor of survival in STEMI patients undergoing primary PCI, motivating investigation into the impact of early successful PPCI on left ventricular ejection fraction.
Does early primary percutaneous coronary intervention (within 6 hours) improve left ventricular ejection fraction and TIMI flow compared to late intervention (6-24 hours) in patients with STEMI?
Does early primary percutaneous coronary intervention (within 6 hours) improve left ventricular ejection fraction and TIMI flow compared to late intervention (6-24 hours) in patients with STEMI?
In patients with STEMI, primary PCI performed within 6 hours of symptom onset is associated with better angiographic reperfusion and preserved left ventricular systolic function at 3 months compared to delayed intervention.
Supports earlier PPCI in STEMI; hypothesis-generating observational data requiring RCTs before practice change.
Background: Treatment delay is considered to be one of the important predictors of survival in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated the impact of early successful PPCI for STEMI patients on left ventricular ejection fraction. Methodology: This prospective study was carried out on 50 patients having STEMI undergoing PPCI in NICVD Karachi. Patients were divided into two groups, Group A, early presenter, patients received treatment with PPCI within six hours of the onset of symptoms, and group B, late presenter, patients received treatment after six hours up to twenty-four hours of the onset of symptoms. Results: Group A patients showed promising results, having achieved TIMI grade III flow in 100%, whereas 85% of patients achieved TIMI grade III flow in group B (P = 0.02). There was a statistical difference between the two groups. Using Independent sample T-Test Group A patients showed improved LVEF as compared to Group B (at presentation 45.49±3.99% vs. 35.25±3.85%; P = 0.001 and at 3 months follow up 55.66±0.92% vs. 45.75±1.44%; P = 0.001). Conclusion: Early PPCI treatment of STEMI patients can lead to improved TIMI grade flow and LVEF. Efforts must be made to shorten the delay in reperfusion therapy.
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Haq et al. (2022) studied this question.
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