Key result
Primary PCI linked to ~12-point lower 30-day mortality vs. pharmacoinvasive strategy.
Why the study?
Myocardial infarction in Palestine is managed mainly by primary PCI or a pharmacoinvasive approach with tissue plasminogen activator, and the study aimed to identify and compare postoperative complications and demographic differences between both approaches in two tertiary centers in the West Bank.
Does primary percutaneous coronary intervention reduce postoperative complications and 30-day mortality compared to a pharmacoinvasive strategy in adults with ST-elevation myocardial infarction in Palestine?
Cohort (n=160)
Yes
Does primary percutaneous coronary intervention reduce postoperative complications and 30-day mortality compared to a pharmacoinvasive strategy in adults with ST-elevation myocardial infarction in Palestine?
Answers are grounded in this paper and cite their sources.
In Palestinian tertiary centers, STEMI patients treated with a pharmacoinvasive approach experienced significantly higher postoperative complications and 30-day mortality compared to those undergoing primary PCI.
Background Myocardial infarction (MI) is among the most diagnosed cardiological diseases in the whole world and in Palestine, and is managed mainly by percutaneous coronary intervention (PCI), or in addition of tissue plasminogen activator (tPA), i.e., pharmacoinvasive approach. The aim of the current study is to identify the most common postoperative complications, and compare differences according to demographic factors, in both approaches in two tertiary centers in West Bank – Palestine. Methodology A retrospective cohort design was utilized on a randomized sample of 160 adult (30–75 years old) patients who were admitted to intensive care cardiology departments of Palestine Medical complex (for pharmacoinvasive approach) and An-Najah National University Hospital (for PCI approach). The researcher used a data sheet that was developed based on previous literature, and data were analyzed using SPSS software. Results Patients who underwent PCI (n = 82, 51.2%) were significantly older (mean = 59.8 ± 9.7 vs 56.2 ± 12.7) than pharmacoinvasive (n = 78, 48.8%), with more radial site of insertion use (95.1% vs. 15.4%), and no significant difference in MI location. PCI patients showed more significant decrease in some laboratory tests and heart rate, with more significant increase in troponin-I, compared to pharmacoinvasive patients (p-value < 0.05) between pre- and post-operative phases. Most postoperative complications, and mortality rate, were significantly higher among pharmacoinvasive patients (p-value < 0.05). Lastly, significantly more postoperative complications were found among patients with dyslipidemia, valve regurgitation and cardiac hypokinesia. Conclusion Patients who were treated with pharmacoinvasive approach showed higher postoperative complications and 30-day mortality rate. More research is needed in this area of cardiology management in Palestine. A prospective design is also recommended to be conducted for this topic in the future research.
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Hayek et al. (2026) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=160). Primary percutaneous coronary intervention (PCI) vs. Pharmacoinvasive strategy (tissue plasminogen activator [tPA] followed by coronary angiography/PCI) was evaluated on 30-day mortality (p=0.004). Primary PCI was associated with a significantly lower 30-day mortality rate (1.2% vs 12.8%, p=0.004) and fewer postoperative complications (20.7% vs 66.7%, p<0.001) compared to a pharmacoinvasive strategy.
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