Three-Year Clinical Outcomes Based on Pre-Percutaneous Coronary Intervention Coronary Blood Flow Grade and Symptom-to-Balloon Time in Patients with Non-ST-Segment Elevation Myocardial Infarctionopen access
- Authors
- Kim, Yong Hoon; Her, Ae-Young; Rha, Seung-Woon; Choi, Cheol Ung; Choi, Byoung Geol; Park, Soohyung; Kang, Dong Oh; Cho, Jung Rae; Park, Ji Young; Park, Sang-Ho; Jeong, Myung Ho
- Issue Date
- May-2023
- Publisher
- MDPI AG
- Keywords
- non-ST-segment elevation myocardial infarction; percutaneous coronary intervention; reperfusion
- Citation
- Journal of Clinical Medicine, v.12, no.11
- Journal Title
- Journal of Clinical Medicine
- Volume
- 12
- Number
- 11
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/25311
- DOI
- 10.3390/jcm12113654
- ISSN
- 2077-0383
2077-0383
- Abstract
- We compared the 3-year clinical outcomes according to the degree of pre-percutaneous coronary intervention thrombolysis in myocardial infarction flow grade (pre-PCI TIMI) and symptom-to-balloon time (SBT) individuals who underwent successful stent implantation with a diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI). A total of 4910 patients with NSTEMI were divided into two groups: pre-PCI TIMI 0/1 (SBT < 48 h: n = 1328, SBT = 48 h: n = 558) and pre-PCI TIMI 2/3 (SBT < 48 h: n = 1965, SBT = 48 h: n = 1059). The primary outcome was a 3-year all-cause death rate, and the secondary outcome was the composite endpoint of 3-year all-cause death, recurrent MI, or any repeat revascularization rate. After adjustment, in the pre-PCI TIMI 0/1 group, the 3-year all-cause death (p = 0.003), cardiac death (CD, p < 0.001), and secondary outcome (p = 0.030) values were significantly higher in the SBT >= 48 h group than in the SBT < 48 h group. However, patients with pre-PCI TIMI 2/3 had similar primary and secondary outcomes, regardless of the SBT group. Within the SBT < 48 h group, the pre-PCI TIMI 2/3 group exhibited significantly higher rates of 3-year all-cause death, CD, recurrent MI, and secondary outcome values than the pre-PCI TIMI 0/1 group. Patients in the SBT >= 48 h group with either pre-PCI TIMI 0/1 or TIMI 2/3 had similar primary and secondary outcomes. Our results suggest that shortening the SBT may confer a survival benefit in patients with NSTEMI and those in the pre-PCI TIMI 0/1 group compared to those in the pre-PCI TIMI 2/3 group.
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