Why the study?
Up to 40% of STEMI patients present late, but data on clinical outcomes in patients treated with primary PCI 12 or more hours after symptom onset were lacking.
Does primary percutaneous coronary intervention performed later than 12 hours after symptom onset increase the risk of all-cause mortality and hospitalisation for heart failure in STEMI patients?
Does primary percutaneous coronary intervention performed later than 12 hours after symptom onset increase the risk of all-cause mortality and hospitalisation for heart failure in STEMI patients?
Delaying primary PCI beyond 12 hours from symptom onset in STEMI patients is associated with increased risk of mortality and heart failure hospitalization.
Late primary PCI ≥12 h after STEMI onset was associated with higher adverse events; leaves open whether timing is causal or warrants randomized trials.
BACKGROUND: Up to 40% of patients with ST-segment elevation myocardial infarction (STEMI) present later than 12 hours after symptom onset. However, data on clinical outcomes in STEMI patients treated with primary percutaneous coronary intervention 12 or more hours after symptom onset are non-existent. We evaluated the association between primary percutaneous coronary intervention performed later than 12 hours after symptom onset and clinical outcomes in a large all-comer contemporary STEMI cohort. METHODS: All STEMI patients treated with primary percutaneous coronary intervention in eastern Denmark from November 2009 to November 2016 were included and stratified by timing of the percutaneous coronary intervention. The combined clinical endpoint of all-cause mortality and hospitalisation for heart failure was identified from nationwide Danish registries. RESULTS: <0.001). CONCLUSIONS: Increasing duration from symptom onset to primary percutaneous coronary intervention was associated with an increased risk of an adverse clinical outcome in patients with STEMI, especially when the delay exceeded 12 hours.
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Nepper‐Christensen et al. (2020) studied this question.
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