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23.Matter of Time: Early Versus Late Percutaneous Coronary Intervention in Acute Coronary Syndrome
Iqtidar Ud Din1, Tanveer Ahmed2, Umair Ali1, Shoaib Subhan3, Yasir Arafat1 and Muhammad Ishaq1
ABSTRACT
Objective: To find the outcomes of patients undergoing early versus late percutaneous coronary intervention after Acute Myocardial Infarction.
Study Design: Cross sectional Study
Place and Duration of Study: This study was conducted at Cardiology Unit of Qazi Hussain Ahmed Medical Institute, Nowshera from January 2021 to June 2021 for a period of six months.
Materials and Methods: Study included 200 patients including 120 males. Mean age was 55±5.60 years. Patients presented with acute myocardial infarction, undergoing percutaneous coronary intervention were included. Patients were divided into two groups on the basis of time to intervention. Group 1 comprised of patients in which intervention was done in 24hr to 72 hrs, while Group 2 consisted of patients with intervention done after 7 days of presentation. Patients were then followed to look for primary outcomes like Myocardial infarction (STEMI, NSTEMI), cardiac death and angina in 6 months. Student t test and Chi Square used for analysis.
Results: About 58.60% patients presented with STEMI while 41.40 % with NSTEMI. Group 1 consisted of 90 patients and Group 2 consisted of 110 patients. Mean EF of patients was 43.8±9%. Mean stent diameter was significantly smaller in group 1 (2.7±0.31 vs. 3.2±0.41 mm, p=0.04) while stent length was more in Group 2 (p=0.05). In total 12.5% patients had primary adverse events with cardiac mortality of 2.5%. On compilation, 13.33% of patients in the Group 1 and 15.45 % of patients in Group 2 suffered from primary adverse outcomes (p=0.11). Mortality rate was found not much different between the 2 groups (p=0.14).
Conclusion: Percutaneous coronary intervention has no doubt greater benefit in patients with acute myocardial infarction but timings of intervention after 24hr of presentation especially in stable patients does not differ much.
Key Words: Percutaneous Coronary Intervention (PCI), ST Elevation Myocardial Infarction (STEMI), Non ST Elevation Myocardial Infarction (NSTEMI), Recurrent Angina (RA)
Citation of article: Iqtidar Ud Din, Ahmed T, Ali U, Subhan S, Arafat Y, Ishaq M. Matter of Time:
Early Versus Late Percutaneous Coronary Intervention in Acute Coronary Syndrome. Med Forum 2021;32(12):98-101.