Thirty-Day Clinical Outcome of Primary Percutaneous Intervention Versus Fibrinolysis Followed by Coronary Angiography in ST-Segment Elevation Myocardial Infarction

Abstract

follow up clinics notes and via phone calls. Data interpreted by using logistic regression analysis. Results: 176 patients were studied. Mean age 54.0 years, of which 86.9% were male. 11 patients (6.3%) died within 30 days after PPCI. No significant difference in outcome for gender and age groups. Prolonged door in door out (DIDO) at primary hospital showed higher mortality rate (b30 minutes: 4.8% p=0.549, 30-60min: 5.3% p=0.708, N60min: 11.1% p=0.165). Longer door to device (DTD) duration is associated with higher mortality rate in both PCI-capable Hospital (b90minutes: 4.8% vs N90min: 12.5%, p=0.342) and non-PCI-capable hospitals (b120min: 3.6% vs N120min: 9.1% p=0.359). Systolic blood pressure(BP) is significant factor affecting patients' outcome (Odd Ratio (OR)=0.959 (0.935-0.983), p=0.001). Systolic BP b 100mmHg (OR 4.339 (1.295-14.543), p=0.045), and diastolic BP b 60mmHg (OR= 4.339 (1.295-14.543), p=0.045) are associated with high mortality. Patients presented with Killip I (OR 0.202 (0.062-6.59), p=0.008) had favorable outcome while patients presented with Killip IV (OR 6.151 (2.056-18.40), p=0.04) had poor outcome in this study. Conclusion: PPCI for acute STEMI 30 days mortality rate is 6.3%. Outcome of patients with Killip IV remained poor despite immediate intervention. Blood pressure is an important factor predicting patients' outcome. Shorter transfer time associated with better outcome but not statistically significant. As STEMI network in this region is expanding, a more comprehensive outcomes study will be obtained with longer study period and bigger sample size.