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Late percutaneous coronary intervention prevents left ventricular remodeling and improves clinical outcomes in

Yan Fan1, Xiaojun Bai, Yuewu Chen

  • 1Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, and Institute of Cardiovascular Channelopathy, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education, Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, Shaanxi, China.

Clinical Cardiology
|February 5, 2015
PubMed

Insights

Late percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) prevents adverse left ventricular remodeling. This strategy significantly reduces major adverse cardiovascular events, all-cause death, and heart failure rehospitalization compared to conservative treatment.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Optimal treatment strategies for late presenters of ST-elevation myocardial infarction (STEMI) are not well-defined.
  • Left ventricular (LV) remodeling and clinical outcomes in these patients require further investigation.

Purpose of the Study:

  • To evaluate the effect of percutaneous coronary intervention (PCI) on LV remodeling and clinical outcomes in patients with STEMI presenting late.
  • To compare the efficacy of late PCI versus conservative medical therapy in managing STEMI.

Main Methods:

  • A cohort of 1090 STEMI patients hospitalized between 2009-2011 in China were analyzed.
  • Patients underwent either late PCI (n=786) or received standard medical therapy (n=304).
  • Cardiac characteristics were assessed via echocardiography, with clinical endpoints evaluated over a median 36-month follow-up.

Main Results:

  • Late PCI was independently associated with reduced LV remodeling (OR: 0.356, P < 0.001).
  • Kaplan-Meier analysis revealed lower risks of major adverse cardiovascular events (MACE), all-cause death, and heart failure rehospitalization in the late PCI group.
  • Multivariate analysis confirmed these benefits in both all and propensity-score matched patients (all P < 0.016).

Conclusions:

  • A late PCI strategy effectively prevents LV remodeling in STEMI patients.
  • This approach significantly improves clinical outcomes, including reduced MACE, mortality, and rehospitalization, compared to conservative management.
Abstract

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