Key result
PPCI shows no survival benefit over thrombolysis after adjusting for age.
Why the study?
The study aimed to compare the survival rate of STEMI patients treated with thrombolysis versus primary percutaneous coronary intervention (PPCI).
Does primary percutaneous coronary intervention improve survival compared to thrombolysis in patients with STEMI?
Cohort (n=354)
Does primary percutaneous coronary intervention improve survival compared to thrombolysis in patients with STEMI?
Absolute Event Rate: 92.4% vs 83.9%
In this observational cohort of STEMI patients, the apparent survival benefit of PPCI over thrombolysis was attenuated after adjusting for confounders, with only age remaining a significant predictor of mortality.
PPCI linked to higher STEMI survival than thrombolysis in this cohort; leaves open selection bias, requiring randomized confirmation.
Background Cardiovascular diseases are the leading cause of death worldwide, and myocardial infarction is one of the common manifestations of these diseases. The goal of this study was to compare the survival rate of patients treated with thrombolysis and PPCI in patients with STEMI. Method This was a survival analysis study performed on 354 patients in Shiraz, Iran. Admission time was considered as the starting point and the time of death or the last follow-up time as the endpoint. All cases of STEMI patients were reviewed from the beginning to the end of 2018. Data were collected using a checklist and telephone call and they were analyzed using the Log Rank test, Kaplan-Meier and Cox regression models. Results The overall survival rate of patients in the PPCI group (92.4%) was significantly higher than that of the thrombolysis group (83.9%). The variables such as age, gender, diabetes history and type of treatment had an impact on the risk of death. After controlling the confounding factors, only the patients' age had a significant effect on death (HR: 1.05, P = 0.001, 95% CI: 1.02–1.09). Conclusions The survival rate of the PPCI group was higher than thrombolysis group. However, the difference in the criteria used to select the type of treatment may have a distorting effect on the subject. Therefore, it seems necessary to carry out studies with a more appropriate design.
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Izadpanah et al. (2020) conducted a cohort in ST-Segment elevation myocardial infarction (STEMI) (n=354). Primary percutaneous coronary intervention (PPCI) vs. Thrombolysis was evaluated on Overall survival rate. Although unadjusted survival was higher with primary percutaneous coronary intervention than thrombolysis (92.4% vs 83.9%), only age remained a significant predictor of death after adjustment.
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