Benefit of percutaneous coronary intervention in early latecomers with acute ST-segment elevation myocardial infarction

Doo Sun Sim, Myung Ho Jeong, Youngkeun Ahn, Young Jo Kim, Shung Chull Chae, Taek Jong Hong, In Whan Seong, Jei Keon Chae, Chong Jin Kim, Myeong Chan Cho, Seung Woon Rha, Jang Ho Bae, Ki Bae Seung, Seung Jung Park

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Abstract

The clinical benefit of percutaneous coronary intervention (PCI) is controversial in stable early latecomers with ST-segment elevation myocardial infarction (STEMI). We evaluated the efficacy of PCI in 2,344 stable patients with STEMI presenting 12 to 72 hours after symptom onset. Patients who had impaired hemodynamics or who had undergone fibrinolysis or immediate or urgent PCI were excluded. The patients were divided into the PCI group (n = 1,889) and medical treatment group (n = 455). The 12-month clinical outcome was compared between the 2 groups. After adjustment using propensity score stratification, the PCI group had lower mortality (3.1% vs 10.1%; hazard ratio 0.31; 95% confidence interval 0.20 to 0.47; p <0.001) and a lower incidence of composite death/myocardial infarction (3.8% vs 11.2%; hazard ratio 0.36; 95% confidence interval 0.25 to 0.53; p <0.001) at 12 months. The benefit of PCI was consistent across all subgroups, including patients presenting without chest pain. In conclusion, in stable patients with STEMI presenting 12 to 72 hours after symptom onset, PCI was associated with significant improvement in the 12-month clinical outcome.

Original languageEnglish
Pages (from-to)1275-1281
Number of pages7
JournalAmerican Journal of Cardiology
Volume110
Issue number9
DOIs
Publication statusPublished - 2012 Oct 1

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Sim, D. S., Jeong, M. H., Ahn, Y., Kim, Y. J., Chae, S. C., Hong, T. J., Seong, I. W., Chae, J. K., Kim, C. J., Cho, M. C., Rha, S. W., Bae, J. H., Seung, K. B., & Park, S. J. (2012). Benefit of percutaneous coronary intervention in early latecomers with acute ST-segment elevation myocardial infarction. American Journal of Cardiology, 110(9), 1275-1281. https://doi.org/10.1016/j.amjcard.2012.06.028