Key result
Delayed PCI linked to reduced angiographic thrombus vs immediate PCI after successful STEMI reperfusion.
Why the study?
The optimal timing of facilitated PCI after successful pharmacological reperfusion in STEMI patients was uncertain.
Does immediate PCI <2 hours compared to delayed PCI (12-72 hours) improve outcomes in STEMI patients with successful pharmacological reperfusion?
Cohort
Does immediate PCI <2 hours compared to delayed PCI (12-72 hours) improve outcomes in STEMI patients with successful pharmacological reperfusion?
Delayed facilitated PCI (12-72 hours) appears safe and may reduce angiographic thrombus formation compared to immediate PCI (<2 hours) in STEMI patients with successful pharmacological reperfusion.
May support delayed PCI after successful reperfusion; hypothesis-generating, needs larger RCTs for outcomes.
The study was aimed to investigate the outcomes in patients initially successfully treated pharmacologically and immediate PCI <2 hours, and in patients initially successfully treated with pharmacological therapy and delayed PCI (12-72 hours). All patients had to have successful reperfusion, to receive the combination of a standard abciximab infusion plus half dose rtPA. Similar results were observed in both groups. Delayed PCI group showed a favorable trend in restenosis and bleedings (ns) and a significant reduced angiographic evidence of thrombus formation in IRA. Our very preliminary data suggest the safety and possible use of delayed facilitated PCI in patients with STEMI. The studied patients have successful reperfusion and TIMI-3 flow and our data may not apply to patients with TIMI 0-2 flow.
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Pasquale et al. (2005) conducted a cohort in ST-segment elevation myocardial infarction (STEMI). Immediate PCI (<2 hours) vs. Delayed PCI (12-72 hours) was evaluated. Delayed PCI (12-72 hours) significantly reduced angiographic thrombus formation compared to immediate PCI (<2 hours) in STEMI patients with successful pharmacological reperfusion.
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