Mortality outcome of out-of-hours primary percutaneous coronary intervention in the current era

Abstract

This study of real-world, unselected STEMI patients demonstrates that in a large, well-staffed centre, PPCI outside routine-working hours is safe with no difference in outcome of in-hospital and long-term mortality compared with PPCI during routine-working hours.

Time of symptom onset and value of myocardial blush and infarct size on prognosis in patients with ST-elevation myocardial infarction

“…These conflicting results may be due to presentation of sicker patients and less successful PCI procedures during off-hours (Glaser et al, 2008). However, a recent study by Noman et al (2012) did not find any differences. In our study, procedural success rates showed no significant differences between the groups, although there was a trend toward lower success rates in group 1.…”

“…Several studies have assessed in-hospital, medium and long-term outcomes for PCI therapy during on-hours compared to off-hours. Distinct longer delay times during off-hours are found in most of these studies, but there are conflicting results in terms of angiographic and clinical outcomes for patients treated during off-hours (Beohar et al, 2001;Berger et al, 2006;Casella et al, 2011;Cubeddu et al, 2013;De Luca et al, 2005;Jneid et al, 2008;Noman et al, 2012;Ortolani et al, 2007;Sadeghi et al, 2004;Saleem et al, 2004;Uyarel et al, 2009;Zahn et al, 1999). These conflicting results may be due to presentation of sicker patients and less successful PCI procedures during off-hours (Glaser et al, 2008).…”

Time-Trend Analyses of Bleeding and Mortality After Primary Percutaneous Coronary Intervention During Out of Working Hours Versus In-Working Hours

“…Our observation of differences in transradial access during IWH and OWH is not new and has been previously reported. 16 It would be interesting to explore the trends in transradial access use, bleeding complications, and mortality over time in other cardiac networks/centers.…”

“…[10][11][12][13][14][15][16] A recent meta-analysis has shown increased mortality in patients undergoing PPCI during OWH. 17 It is difficult to compare these studies because of differences in patient characteristics, treatment(s) provided, and the variable definitions of routine working hours.…”

“…17 It is difficult to compare these studies because of differences in patient characteristics, treatment(s) provided, and the variable definitions of routine working hours. Given that most patients with STEMI present during OWH, 16 evaluation of outcomes after PPCI during OWH is crucial given the widespread adoption of round-the-clock programs. Whether PPCI during OWH affects other outcomes, for example, bleeding, is unknown.…”