Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients With Symptom Onset >12 Hours: Data from...

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
• Optimal timing for reperfusion therapy in STEMI remains an area of research.
• Late percutaneous coronary intervention (PCI) is increasingly utilized in clinical practice.

Purpose of the Study:

• To evaluate the efficacy and safety of late PCI (>12 hours) in STEMI patients.
• To compare outcomes of late PCI versus drug therapy alone.
• To assess the impact of late PCI on cardiac function and long-term survival.

Main Methods:

• Prospective, nationwide, multicenter registry in China (China Acute Myocardial Infarction registry).
• Inclusion of patients with STEMI who underwent late PCI or received drug therapy.
• Statistical analysis using Hazard Ratios (HR) and 95% Confidence Intervals (CI) to compare outcomes.

Main Results:

• PCI group showed significantly lower rates of 2-year major adverse cardiac and cerebrovascular events (MACCE), all-cause death, myocardial infarction, stroke, and revascularization compared to drug therapy.
• Hazard ratios indicated substantial risk reduction for PCI across all major adverse events.
• Improved left ventricular ejection fraction was observed in the PCI group after 2-year follow-up, unlike the drug therapy group.

Conclusions:

• Late PCI is a common and beneficial strategy in Chinese clinical practice for STEMI management.
• Late PCI is associated with significant improvements in cardiac function and long-term survival.
• PCI demonstrates superior outcomes compared to drug therapy alone in selected STEMI patients presenting late.