scholarly journals Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110005
Author(s):  
Guoyu Wang ◽  
Ruzhu Wang ◽  
Ling Liu ◽  
Jing Wang ◽  
Lei Zhou
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Index ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Shock Index ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Objective We aimed to determine whether the prognostic value of the shock index (SI) and its derivatives is better than that of the Thrombolysis In Myocardial Infarction risk index (TRI) for predicting adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A total of 257 patients with STEMI undergoing primary PCI from January 2018 to June 2019 were analyzed in a retrospective cohort study. The SI, modified shock index (MSI), age SI (age × the SI), age MSI (age × the MSI), and TRI at admission were calculated. Clinical endpoints were in-hospital complications, including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia. Results Multivariate analyses showed that a high SI, MSI, age SI, age MSI, and TRI at admission were associated with a significantly higher rate of in-hospital complications. The predictive value of the age SI and age MSI was comparable with that of the TRI (area under the receiver operating characteristic curve: z = 1.313 and z = 0.882, respectively) for predicting in-hospital complications. Conclusions The age SI and age MSI appear to be similar to the TRI for predicting in-hospital complications in patients with STEMI undergoing primary PCI.

scholarly journals Trends in reperfusion therapy for acute ST-segment elevation myocardial infarction in an academic PCI centre in the metropolitan area of a developing country

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Dharma ◽  
I Dakota ◽  
H Andriantoro ◽  
I Firdaus ◽  
I.G Limadhy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Metropolitan Area ◽  
Coronary Intervention ◽  
Reperfusion Therapy ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Abstract Background Long-term reports on reperfusion therapy for acute ST-segment elevation myocardial infarction (STEMI) in developing countries are scarce. Purpose We reported changes in acute reperfusion therapy for STEMI that have been observed over time in an academic tertiary care percutaneous coronary intervention (PCI) centre that hosting a STEMI network in the large metropolitan area of Jakarta, Indonesia since 2010 and covering around 11 million inhabitants. Methods A retrospective analysis was performed in 6336 patients with STEMI who admitted to the emergency department of a PCI centre in 2008 (before STEMI network introduction), and during 2011 to 2018. Results Among STEMI patients admitted during 2011–2018 (mean age: 56±10 years, 86% male), 57.6% had anterior wall myocardial infarction, and 71.3% presented with Killip classification I. Compared with the period 2011–2014 (N=2766), patients who were admitted in the period 2015–2018 (N=3250) were receiving more primary percutaneous coronary intervention (PCI) (61.6% vs. 44.2%, P<0.001) with shorter door-to-device time (median 72 min versus 97 min, P<0.001), and less in-hospital fibrinolytic therapy (2.7% vs. 4.8%, P<0.001). The percentage of STEMI patients who did not receive reperfusion treatment decreased from 51% to 35.5% (P<0.001). In-hospital mortality declined from 10% in 2008 (before the STEMI network was initiated) and 8% in 2011 to 6.4% in 2018 (P for trends = 0.05). Multivariable analysis showed that primary PCI was significantly associated with better in-hospital survival (adjusted odds ratio, 0.52; 95% confidence interval, 0.42 to 0.65, P<0.001). Conclusion The data indicate that the introduction of a STEMI network resulted in more patients receiving timely primary PCI and lower early mortality rates in recent years. Funding Acknowledgement Type of funding source: None

Percutaneous Coronary Intervention without On-site Surgical Back-up

2009 ◽  
Vol 4 (1) ◽  
pp. 12
Author(s):  
Gregory J Dehmer ◽  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Number Of Patients ◽  
Percutaneous Coronary ◽  
The Us

Although accepted in several countries, in the US the performance of percutaneous coronary intervention (PCI) without on-site surgical back-up remains controversial. The current US guidelines do not endorse elective PCI in facilities without on-site surgical back-up, but acknowledge that primary PCI for ST-segment elevation myocardial infarction (STEMI) is acceptable under carefully regulated and monitored circumstances. In the US, survey data indicate that either primary PCI alone or primary and elective PCI without on-site surgery is currently being performed in all but seven states, and the number of patients treated in this setting is increasing. Several recent reports continue to document the safety of PCI without on-site surgical back-up, but have limitations as these data are from retrospective reviews or prospective registries. Although it appears that primary and elective PCI without on-site surgery is safe, it is not clear that this is the best way to deliver PCI care to the majority of patients.

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