Impact of infarct-related artery patency before primary PCI on outcome in patients with ST-segment elevation myocardial infarction: the HORIZONS-AMI trial
Key result
Early infarct-related artery patency before primary PCI in patients with STEMI was an independent predictor of reduced one-year mortality (HR 0.58; 95% CI 0.36-0.98; P=0.02).
Why the study?
Does early infarct-related artery patency before primary PCI reduce one-year mortality in patients with STEMI?
Study Design
Type
Cohort (n=3,093)
Multicenter
Yes
Structured PICO
Does early infarct-related artery patency before primary PCI reduce one-year mortality in patients with STEMI?
P
Population
3,093 patients with STEMI treated with primary PCI to a single artery, followed for one year.
E
Exposure
Early infarct-related artery (IRA) patency (TIMI 2 or 3 flow) at baseline coronary angiography before primary PCI
C
Comparator
Absence of early IRA patency (TIMI 0 or 1 flow) at baseline coronary angiography
O
Outcome
One-year mortalityhard clinical
Main Result
Hazard Ratio: 0.58 (95% CI 0.36–0.98)
Absolute Event Rate: 2.5% vs 3.9%
p-value: p=0.02
Early infarct-related artery patency before primary PCI in STEMI patients is an independent predictor of lower one-year mortality and is associated with better post-PCI angiographic results.
Authors
Discussion
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Implication
May inform pre-PCI risk stratification in STEMI; leaves open whether promoting early patency improves survival.
Cite This Study
Rakowski et al. (2013) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=3,093). Early infarct-related artery (IRA) patency vs. Absence of early IRA patency (TIMI 0 or 1 flow) was evaluated on One-year mortality (HR 0.58, 95% CI 0.36-0.98, p=0.02). Early infarct-related artery patency before primary PCI in patients with STEMI was an independent predictor of reduced one-year mortality (HR 0.58; 95% CI 0.36-0.98; P=0.02).