Key result
Flow worsening during primary percutaneous coronary intervention was significantly associated with an increased risk of major adverse cardiac events (HR 3.24) in STEMI patients despite achieving a door-to-balloon time <90 minutes.
Why the study?
Some STEMI patients experience poor clinical outcomes despite achieving door-to-balloon time <90 minutes, indicating a need to identify other therapeutic targets.
Cohort (n=383)
No
Hazard Ratio: 3.24 (95% CI 1.79–5.86)
p-value: p=<0.001
Even when door-to-balloon time is <90 minutes, STEMI patients remain at risk for MACE due to factors like low BMI, high Killip class, prior MI, and procedural flow worsening, highlighting the need for additional therapeutic targets beyond rapid reperfusion.
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Flow worsening during PCI was associated with higher MACE despite timely reperfusion; leaves open whether targeted interventions improve STEMI outcomes.
Tsukui et al. (2020) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=383). Flow worsening during PCI vs. No flow worsening was evaluated on Major adverse cardiac events (MACE) defined as the composite of all-cause death, acute myocardial infarction, and acute heart failure requiring hospitalization (HR 3.24, 95% CI 1.79-5.86, p=<0.001). Flow worsening during primary percutaneous coronary intervention was significantly associated with an increased risk of major adverse cardiac events (HR 3.24) in STEMI patients despite achieving a door-to-balloon time <90 minutes.
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