Trends in percutaneous coronary intervention from 2004 to 2013 according to the Portuguese National Registry of Interventional Cardiology

“…Fourth, they also failed to report the prevalence of predilation, which is a known predictor of mortality, and the no‐reflow phenomenon . Finally, significant alterations have been made to the standards of care for patients with acute coronary syndrome since 2001–2006, the time period of the study by Zhang et al These changes include the enhanced accessibility of PCI, the routine deployment of drug‐eluting stents, the clarification of the role of thrombus aspiration, and the usage of high‐dose statin therapy in patients with acute coronary syndrome suffering acute MI . Although our study was also carried out between 2011 and 2015 and, thus, more or less deviates from the most recent developments in this field, we can safely argue that our study method is more compliant with the current standards of care in patients with STEMI.…”

Section: Discussionmentioning

confidence: 86%

“…mortality, 19,20 and the no-reflow phenomenon. 21 Finally, significant ity of PCI, the routine deployment of drug-eluting stents, 22,23 the clarification of the role of thrombus aspiration, [24][25][26] and the usage of high-dose statin therapy in patients with acute coronary syndrome suffering acute MI. 27 Although our study was also carried out between 2011 and 2015 and, thus, more or less deviates from the most recent developments in this field, we can safely argue that our study method is more compliant with the current standards of care in patients with STEMI.…”

Section: Several Methodologic Differences Between Our Study and That Bymentioning

confidence: 99%

Short‐term safety and long‐term benefits of stent postdilation after primary percutaneous coronary intervention: Results of a cohort study

Saadat

Saadatagah

Nargesi

et al. 2019

Cathet Cardio Intervent

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Aim Achieving the optimal apposition of coronary stents during percutaneous coronary intervention is not always feasible. The risks and benefits of stent postdilation in primary percutaneous coronary intervention (PPCI) in patients with ST‐elevation myocardial infarction (STEMI) have remained controversial. We sought to evaluate the immediate angiographic and long‐term outcomes in patients with and without stent postdilation. Methods A cohort of patients (n = 1,224) with STEMI, treated with PPCI (n = 500 postdilated; n = 724 controls), were studied. The flow grade, the myocardial blush grade, and the frame count were considered angiographic outcomes. The clinical outcomes were major adverse cardiovascular events (MACE)—comprising cardiac death, nonfatal MI, and repeat revascularization—and the device‐oriented composite endpoint (DOCE)—consisting of cardiac death, target lesion revascularization, and target vessel revascularization. Results The flow and myocardial blush grades were not different between the two groups, and the frame count was significantly lower in the postdilation group (15.7 ± 8.4 vs. 17 ± 10.4; p < .05). The patients were followed up for 348 ± 399 days. DOCE (2.2% vs. 5.8%) and cardiac mortality (1.2% vs. 3.2%) were lower in the postdilation group. In the fully adjusted propensity score‐matched analysis, postdilation was associated with decreased DOCE (HR = 0.40 [0.18–0.87], p = .021). Conclusions Selective postdilation improved some angiographic and clinical outcomes and could not be discouraged in PPCI on patients with STEMI.

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“…6 This overall reduction in cardiovascular mortality is certainly related with improvements in pharmacological therapy and to an increase in PCI accessibility. 19 Pereira et al 5 reported a significant increase in P-PCI from 2002 to 2013, thus promoting mortality and morbidity reduction in STEMI patients. The same group 5 also demonstrated the change in the paradigm in STEMI treatment, notably P-PCI overtaking rescue angioplasty as the predominant procedure since 2006.…”

Section: Discussionmentioning

confidence: 99%

Impact of Emergency Medical System Transportation in ST-segment Elevation Myocardial Infarction: A Nationwide Retrospective Study

et al. 2020

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Introduction: Emergency medical system transportation has been shown to reduce treatment times in ST-segment elevation myocardial infarction. The authors studied the Portuguese National Registry of Acute Coronary Syndromes to determine the nationwide impact of the emergency medical system transportation in the treatment of ST-segment elevation myocardial infarction.Material and Methods: A multicentric, nationwide, retrospective study of ST-segment elevation myocardial infarction patients inserted in the National Registry from 2010 to 2017 was performed. The patients were divided into: Group I, composed of patients transported by emergency medical system, and Group II, patients arriving to the Emergency department by other means.Results: Of the 5702 patients studied, 25.9% were transported via emergency medical system. Rates of emergency medical system activation increased by 17% in the last 7 years. The emergency medical system provided a higher rate of transport to a percutaneous coronary intervention capable centre, of Emergency department bypass, of on-site fibrinolysis, and ensured a 59-minute reduction of the median reperfusion time (p < 0.001). There was no difference in in-hospital mortality.Discussion: In this nationwide cohort, emergency medical system transportation is associated with a reduction in reperfusion times. It provides a higher amount of salvaged myocardium and reduces the incidence of acute heart failure. However, emergency medical system use did not result in lower in-hospital mortality, probably due to confounding factors of higher disease severity and comorbidity.Conclusion: The benefits associated with emergency medical system based transportation of patients with ST-segment elevation myocardial infarction do not translate into lower in-hospital mortality.

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Trends in percutaneous coronary intervention from 2004 to 2013 according to the Portuguese National Registry of Interventional Cardiology

Cited by 11 publications

References 24 publications

Trends in primary angioplasty in Portugal from 2002 to 2013 according to the Portuguese National Registry of Interventional Cardiology

Trends in primary angioplasty in Portugal from 2002 to 2013 according to the Portuguese National Registry of Interventional Cardiology

Short‐term safety and long‐term benefits of stent postdilation after primary percutaneous coronary intervention: Results of a cohort study

Impact of Emergency Medical System Transportation in ST-segment Elevation Myocardial Infarction: A Nationwide Retrospective Study

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