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Complete Versus Incomplete Angiography Prior to Percutaneous Coronary Intervention in ST-Elevation Myocardial

Kevin Stiver, Xu Gao, Satya Shreenivas

  • 1Ohio State University Heart and Vascular Center, 473 W. 12th Avenue, Suite 200, Columbus, OH 43210-1252 USA. scott.lilly@osumc.edu.

The Journal of Invasive Cardiology
|March 16, 2017
PubMed

Insights

Incomplete angiography (IA) before percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) shortens door-to-balloon times. However, this approach did not improve short-term patient outcomes in this study.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Shorter reperfusion times in ST-elevation myocardial infarction (STEMI) are linked to better survival rates.
  • Prehospital strategies aim to reduce door-to-balloon (DTB) time, but interventions within the catheterization lab are less studied.
  • Incomplete angiography (IA) is a strategy used to potentially decrease DTB time before percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To evaluate if STEMI patients undergoing IA before PCI have different preprocedural characteristics.
  • To determine if IA prior to PCI impacts post-PCI outcomes in STEMI patients.
  • To compare outcomes between STEMI patients who received IA versus complete angiography (CA) before PCI.

Main Methods:

  • Retrospective review of 256 STEMI patients from March 2013 to December 2015.
  • Comparison of clinical, demographic, and angiographic data between IA and CA groups.
  • Analysis of variance used to compare predictors and outcomes, focusing on DTB times.

Main Results:

  • IA was performed in 26.6% of patients; IA patients were younger.
  • DTB times were significantly shorter in the IA group (28.1 min) compared to the CA group (37.3 min).
  • No significant differences were observed in peak troponin, length of stay, in-hospital mortality, or discharge ejection fraction between groups.

Conclusions:

  • IA is associated with reduced DTB times in STEMI patients undergoing PCI.
  • Despite shorter DTB times, IA did not demonstrate improved short-term clinical outcomes in this patient population.
  • Further research may be needed to clarify the role and impact of IA in STEMI management.
Abstract

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