Staff Members - Benha University
A comparative study on clinical outcomes of pharmacoinvasive strategy versus primary percutaneous coronary intervention in acute myocardial infarction patients
International Heart and Vascular Disease Journal • 2021
Publication Information
Authors
Azmat Khadija Niazi1, Najeeb Jaha1, Liaqat Ali1,2, Sheeren Khaled1,3, Amjad Salim1,
Haroon Al Rashid1, Mousa Abbadi1, Hamdan Al Shehri1, Fatma Aboul-Enein1,
Javaid Iqbal1,4, Ghada Shalaby1,5
Keywords
Pharmacoinvasive strategy, Primary Percutaneous Coronary Intervention, Acute Myocardial Infarction,
ST-Elevation Myocardial Infarction, Thrombolysis in Myocardial Infarction, Left Ventricle
Journal
International Heart and Vascular Disease Journal
Publisher
Not Available
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Not Available
Supplementary Materials
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Abstract
Objective. To compare clinical outcomes of pharmacoinvasive (PI) strategy versus primary percutaneous coronary
intervention (PPCI) in patients with AMI (acute myocardial infarction) still needs more evaluation.
Methods. This is a single centre, retrospective, non-randomized study comparing the two treatment strategies.
A total of 3073 consecutive AMI cases were identified between 2015 and 2019.
Results. The pharmacoinvasive strategy group comprised of 18.5 % (n = 569) and primary PCI group comprised of
81.5 % (n = 2504) patients. The patients in PI group were younger, their mean age was 54.8 ± 12 years vs 56.4 ± 11.5
years (P < 0.003) in PPCI group. Arabic speakers were 47.1 % vs 40.9 % (P < 0.000), South Asians 25.3 % vs 30.2 %
(P < 0.018), smokers 39.9 % vs 31.5 % (P < 0.000) and anterior MI was 55 % vs 54 % (P < 0.000) in PI vs PPCI group
respectively. Transradial approach was utilized in 84.4 % in PI vs 75.4 % (P < 0.000) in PPCI group. Median door to
balloon time (calculated from arrival to our hospital emergency till establishment of TIMI III flow in the culprit vessel)
in PPCI group was 92 minutes. In-hospital mortality tended to be higher in PPCI vs PI as 3.6 % vs 1.9 % (P < 0.049).
LV ejection fraction was observed to be higher in PI group i-e 42.2 ± 11 % vs 40.5 ± 11 % (P < 0.000) in PPCI group.
Conclusion. Pharmacoinvasive strategy has almost equal efficacy as compared with primary PCI and it represents
a reasonable, non-inferior alternative when primary PCI is not readily available especially in patients presenting
early after symptom onset
intervention (PPCI) in patients with AMI (acute myocardial infarction) still needs more evaluation.
Methods. This is a single centre, retrospective, non-randomized study comparing the two treatment strategies.
A total of 3073 consecutive AMI cases were identified between 2015 and 2019.
Results. The pharmacoinvasive strategy group comprised of 18.5 % (n = 569) and primary PCI group comprised of
81.5 % (n = 2504) patients. The patients in PI group were younger, their mean age was 54.8 ± 12 years vs 56.4 ± 11.5
years (P < 0.003) in PPCI group. Arabic speakers were 47.1 % vs 40.9 % (P < 0.000), South Asians 25.3 % vs 30.2 %
(P < 0.018), smokers 39.9 % vs 31.5 % (P < 0.000) and anterior MI was 55 % vs 54 % (P < 0.000) in PI vs PPCI group
respectively. Transradial approach was utilized in 84.4 % in PI vs 75.4 % (P < 0.000) in PPCI group. Median door to
balloon time (calculated from arrival to our hospital emergency till establishment of TIMI III flow in the culprit vessel)
in PPCI group was 92 minutes. In-hospital mortality tended to be higher in PPCI vs PI as 3.6 % vs 1.9 % (P < 0.049).
LV ejection fraction was observed to be higher in PI group i-e 42.2 ± 11 % vs 40.5 ± 11 % (P < 0.000) in PPCI group.
Conclusion. Pharmacoinvasive strategy has almost equal efficacy as compared with primary PCI and it represents
a reasonable, non-inferior alternative when primary PCI is not readily available especially in patients presenting
early after symptom onset