Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction: An Analysis from Tanta-AMI Multicenter Registry

Abstract

Background: The goal of reperfusion therapy in acute myocardial infarction is to swiftly and persistently reperfuse the at-risk myocardium. Traditional reperfusion treatments include thrombolysis and primary percutaneous coronary intervention (PCI), with the latter being the optimal option if administered immediately by an experienced team. This study characterized the presentation, processes, and predictors of care and outcomes of patients with acute myocardial infarction (MI) undergone primary PCI with a focus on procedural and angiographic characteristics and in hospital mortality. Methods: This prospective observational registry was conducted on 945 STEMI patients and treated with PCI, they underwent history taking, full Clinical examinations including resting 12 leads ECG, cardiac examination, venous sampling for laboratory data, cardiac catheterization to perform primary PCI, echocardiography, medical treatment after discharge. Results: It was found that EF of patients at discharge ranged from 22.0-70.0 with a mean value of 45.97 ± 10.07, while at one month follow up was 25.0-70.0 with mean SD 48.87 ± 8.17, at 3 month was 25.0-70.0 with mean SD 48.72 ± 8.26 and at 6 month was 30.0-70.0 with mean SD 48.18 ± 8.13, so there was a significant different in EF at discharge and follow up periods (P value = 0.001). It was noticed that there are significant differences in MACE during follow up periods. There a statically significant different as regard mortality, heart failure, stent thrombosis, repeated hospitalization and re-infarction between follow up after one and three months, one and six months, three and six months (P value < 0.001). Conclusions: PCI is the most common reperfusion therapy for STEMI. Older individuals had a greater risk of in-hospital mortality, AKI, and bleeding complications following PCI than younger patients. Transradial intervention may decrease the frequency of periprocedural complications in PCI patients who are elderly.