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Off-hour presentation and outcomes for percutaneous coronary intervention in acute myocardial infarction with Killip

Seok Oh1, Ju Han Kim1, Kyung Hoon Cho1

  • 1Department of Cardiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.

The Korean Journal of Internal Medicine
|May 5, 2022
PubMed

Insights

Outcomes for severe acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI) were similar regardless of whether the procedure occurred during on- or off-hours. This finding suggests hospital visit timing does not impact long-term clinical results for Killip III-IV AMI.

Area of Science:

  • Cardiology
  • Clinical Research
  • Public Health

Background:

  • Acute myocardial infarction (AMI) necessitates prompt reperfusion therapy, yet optimal timing remains debated.
  • Clinical outcomes based on hospital visit timing for AMI are inconclusive.
  • Severe cases (Killip functional classification III-IV) require specific investigation.

Purpose of the Study:

  • To compare long-term clinical outcomes of percutaneous coronary interventions (PCI) in patients with Killip III-IV AMI.
  • To investigate differences between off-hour and on-hour PCI procedures.

Main Methods:

  • Analysis of 1,751 patients with Killip III-IV AMI from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry (November 2011-June 2015).
  • Patients categorized into off-hour (evenings, nights, weekends, holidays) and on-hour (standard business hours) PCI groups.
  • Primary endpoint: Major adverse cardiac and cerebrovascular events (MACCE) including mortality, nonfatal MI, revascularization, stroke, and stent thrombosis, assessed at 3-year follow-up.

Main Results:

  • 39.1% of patients underwent on-hour PCI (n=572), while 60.9% underwent off-hour PCI (n=892).
  • No significant difference in 3-year clinical outcomes was observed between the on-hour and off-hour PCI groups.
  • Propensity-score weighting adjustment confirmed the similarity in outcomes between the groups.

Conclusions:

  • Clinical outcomes for patients with Killip III-IV AMI are similar regardless of whether PCI is performed during on- or off-hours.
  • Hospital visit timing does not appear to influence long-term results for this high-risk AMI population.
Abstract

Keywords:
Acute coronary syndromeMyocardial infarctionPercutaneous coronary interventionRepublic of KoreaTreatment outcome

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