COMPARING MORTALITY AND COMPLICATIONS IN STEMI BETWEEN TWO TREATMENT GROUPS: PRIMARY PCI AND PHARMACO-INVASIVE GROUPS: MAHARAT NAKHON RATCHASIMA HOSPITAL
Keywords:
STEMI, primary PCI, pharmaco-invasive treatment, Nakhon Ratchasima, ThailandAbstract
The current definitive treatment for STEMI is reperfusion therapy consisting of primary percutaneous coronary intervention (primary PCI) and thrombolysis following PCI within 3–24 h (pharmaco-invasive treatment). The aim of this study was to compare the mortality and complications between 2 groups of patients with STEMI, one undergoing undergoing primary PCI and the other undergoing pharmaco-invasive treatment. A total of 808 patients with STEMI were treated at Maharat Nakhon Ratchasima Hospital from 1st November, 2012 to 31st October, 2013. Among 483 patients who were included in the study, 345 were treated with primary PCI and 138 had pharmaco-invasive treatment. Patients in the primary PCI group are more likely to die and to have more frequent arrhythmic complications when compared with the pharmaco-invasive group (11.6% vs. 9.4%, p = 0.490 and 11.9% vs. 10.1%, p = 0.587, respectively. Patients in the primary PCI group had statistically significantly less TIMI minor bleeding complications than the pharmaco-invasive group (3.5% vs. 9.4%, CI 1.282-6.495; p = 0.008). Door-to-balloon time (from the first medical contact) was longer than door-to-needle time. In this study, the difference between door-to-balloon time and door-to-needle time, the PCI-related delay was 95.5 min. In summary, there was a time delay in treatment for STEMI in Nakhon Ratchasima province, with both the primary PCI and pharmaco-invasive treatment strategies. Due to the lack of a PCI center and the time delay in the transfer for primary PCI, pharmaco-invasive may be the treatment strategy of choice.
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