International Journal of General Medicine (Mar 2022)
Late Percutaneous Coronary Intervention is Associated with Better Prognosis of Patients with Acute Myocardial Infarction
Abstract
Hao Dong,1,* Xuan Li,2,* Dongping Xiao,3 Yong Tang1 1Department of Cardiology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210000, People’s Republic of China; 2Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China; 3Department of Cardiology, The First Hospital of Nanchang, Nanchang, 330000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yong Tang, Department of Cardiology, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 210000, People’s Republic of China, Email [email protected]: 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) 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 24 h after symptom onset, compared to conservative strategies.Keywords: percutaneous coronary intervention, acute myocardial infarction, prognosis
