Association between total ischemic time and in-hospital mortality after emergency PCI in patients with acute ST-segment elevation myocardial infarction: a retrospective study

Abstract

Background Symptom-to-balloon time (SBT) represents the total ischemic time in ST-elevated myocardial infarction (STEMI) and is associated with poor long-term outcomes. The study aimed to explore the association between SBT and in-hospital mortality after emergency percutaneous coronary intervention (PCI) in patients with acute STEMI. Methods This retrospective, multicenter, observational study included patients admitted to the Hebei General Hospital, Baoding No. 1 Central Hospital, and Cangzhou Central Hospital from January 2016 to December 2018. The outcome was all-cause mortality during the hospital stay. Logistic regression models were established to explore the association between SBT and all-cause mortality during the hospital stay. Results This study included 1169 patients: 876 males of 59.6 ± 11.4 years of age, and 293 females 66.3 ± 13.3 years of age. A first analysis showed EF had an interaction with SBT (P = 0.01). In patients with EF ≥ 50%, SBT was not an independent risk factor for postoperative all-cause mortality in the hospital (all P > 0.05). In patients with EF < 50%, SBT was an independent risk factor for postoperative all-cause mortality in the hospital [model 3: 1.51 (1.17, 1.54), P for trend = 0.01]. Conclusions SBT was independently associated with all-cause mortality in the hospital after PCI in patients with acute STEMI and EF < 50%. Specifically, the risk of in-hospital mortality for those with SBT ≥ 361 min is increased by 51% compared with those with SBT ≤ 120 min.

Association between TIMI Risk Score and in-Hospital Mortality in Acute STEMI Patients Undergoing Primary PCI

“…One patient was expired due to high TIMI score. An international study conducted by Gao 21 reported almost same results 21 .…”

Total Ischemic Time on In-Hospital Complication Predictor in ST-Elevation Myocardial Infarction (STEMI) Patients With Renal Dysfunction

“…Numerous studies have demonstrated the connection between TIT and the prognosis following PCI in patients with STEMI [16,22]. This study's key conclusion was the identification of a direct link between TIT and various in-hospital complications, such as pulmonary edema and cardiogenic shock.…”

“…It may be a more powerful prognostic indicator than DTB time, as an increase in microvascular blockage area has been linked to extended ischemia [15]. Gao and co-authors found that in patients with STEMI with ejection fraction (EF) < 50%, TIT was independently correlated with all-cause mortality in the hospital after PCI [16]. The findings of this study also reveal that acute kidney injury, Killip, and thrombolysis in myocardial infarction (TIMI) grade are substantial risk factors for in-hospital death in STEMI patients [16].…”

“…Gao and co-authors found that in patients with STEMI with ejection fraction (EF) < 50%, TIT was independently correlated with all-cause mortality in the hospital after PCI [16]. The findings of this study also reveal that acute kidney injury, Killip, and thrombolysis in myocardial infarction (TIMI) grade are substantial risk factors for in-hospital death in STEMI patients [16]. At a one-year follow-up, another study found that persistent ischemia was associated with death, rehospitalization, and revascularization [17].…”

Predictors of Acute Stent Thrombosis After Primary Percutaneous Coronary Intervention

“…Since the invention of coronary artery stents, stenting has been regarded as the major post-procedural complication of percutaneous coronary intervention stent thrombosis. 1,2 The development of drug-eluting stents (DES) was specically one of the important developments in interventional cardiology. 3,4 With an initial higher risk of acute stent thrombosis, drug-eluting stents have been demonstrated to minimize in-stent restenosis and eventual target lesion revascularization.…”