Long-term outcomes in ST-elevation myocardial infarction patients treated according to hospital visit time

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• ST-elevation myocardial infarction (STEMI) requires rapid percutaneous coronary intervention (PCI).
• Conflicting data exists on clinical outcomes for STEMI patients presenting during on-hours versus off-hours.
• This study addresses the disparity in outcomes between on-hours and off-hours PCI for STEMI.

Purpose of the Study:

• To investigate the long-term clinical outcomes of STEMI patients undergoing PCI during off-hours compared to on-hours.
• To determine if presentation time impacts major adverse cardiac and cerebrovascular events (MACCEs).

Main Methods:

• Analysis of 5,364 STEMI patients from the KAMIR-NIH registry (November 2011 - June 2015).
• Patients categorized into off-hours (evenings, nights, weekends, holidays) and on-hours (weekdays 8 AM - 6 PM) groups.
• Primary endpoint: MACCEs (all-cause mortality, non-fatal MI, revascularization, stroke, stent thrombosis) assessed at 36 months using unadjusted and propensity score weighting-adjusted analyses.

Main Results:

• 3,119 patients (58.1%) presented during off-hours, and 2,245 (41.9%) presented during on-hours.
• At 36 months, long-term clinical outcomes were similar between the off-hours and on-hours PCI groups.
• Propensity score weighting-adjusted analysis confirmed no significant difference in MACCEs between the groups.

Conclusions:

• Long-term outcomes for STEMI patients treated with PCI are comparable regardless of on-hours or off-hours presentation.
• Hospital admission timing does not appear to influence major adverse cardiac and cerebrovascular events in STEMI patients.
• These findings suggest that timely PCI is crucial, irrespective of the time of day or week.