Key result
Late percutaneous coronary intervention significantly reduced the risk of major adverse cardiovascular events (HR 0.367) compared to conservative strategies in AMI patients with HFpEF presenting >24 hours after symptom onset.
Why the study?
The optimal timing of invasive coronary revascularization in patients with late presentation of acute myocardial infarction remains unclear.
Does late percutaneous coronary intervention reduce major adverse cardiovascular events in AMI patients with HFpEF presenting >24 hours after symptom onset?
Observational (n=680)
No
Does late percutaneous coronary intervention reduce major adverse cardiovascular events in AMI patients with HFpEF presenting >24 hours after symptom onset?
Hazard Ratio: 0.367 (95% CI 0.202–0.665)
p-value: p=<0.001
Late-PCI strategy significantly reduces the risk of major adverse cardiovascular events in AMI patients with HFpEF presenting more than 24 hours after symptom onset compared to conservative management.
Background: The optimal timing of invasive coronary revascularization in patients with late presentation of acute myocardial infarction (AMI) remains unclear. Objective: This study aimed to investigate whether late percutaneous coronary intervention (PCI) is associated with the prognosis of AMI patients with HFpEF presenting >24h after symptom onset. Methods: We enrolled 680 AMI patients with HFpEF. Patients were divided into 3 groups: early-PCI strategy (defined as the time to open IRA from symptom onset <24 h), late-PCI strategy (defined as the time of PCI-mediated reperfusion was >24 h) and non-revascularization group. Results: A total of 144 (21.2%) experienced a MACE, including 118 (17.4%) all-cause deaths and 26 (3.8%) re-hospitalization for HF during a follow-up period of 30.20±15.62 months. After adjusting for gender, age, smoking, diabetes mellitus, NT-proBNP and eGFR, late-PCI was a significant and independent predictor of MACE (hazard ratio 0.367; 95% confidence interval 0.202-0.665; p<0.001). Kaplan-Meier analysis showed that late-PCI decreased cumulative risk of MACE (p< 0.001). Conclusion: Late-PCI and early-PCI strategies are associated with a reduced risk of MACE in AMI patients with HFpEF presenting >24 h after symptom onset, compared to conservative strategies.
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A 2022 study conducted an observational in Acute Myocardial Infarction with Heart Failure with Preserved Ejection Fraction (HFpEF) (n=680). Late percutaneous coronary intervention (late-PCI) vs. Non-revascularization (conservative strategy) was evaluated on Major adverse cardiovascular events (MACE), a composite of total death, hospitalization for HF, and revascularization (HR 0.367, 95% CI 0.202-0.665, p=<0.001). Late percutaneous coronary intervention significantly reduced the risk of major adverse cardiovascular events (HR 0.367) compared to conservative strategies in AMI patients with HFpEF presenting >24 hours after symptom onset.
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