Factors Affecting Outcome of Rescue Percutaneous Coronary Intervention in Acute Myocardial Infarction
Background: Rescue PCI (Percutaneous Coronary Intervention) in STEMI (ST Elevation Myocardial Infarction) performed with favorable outcome in patients that experience failure of reperfusion therapy, although limited information on the major predictors of outcome. Aim: Identify factors affecting Rescue PCI in STEMI as regard incidence of Major Adverse Cardiac Events (MACE) early after PCI in hospital& after six months of intervention.
Methods: This was a retrospective cross-sectional study assessed 120 patients receiving rescue PCI for STEMI. Effects of some factors including age, sex, coronary artery risk factors, time from symptoms onset to admission, time from failure of reperfusion to start PCI, Left Ventricular Function Ejection Fraction (LVEF), Thrombolysis In Myocardial Infarction (TIMI) flow, and type of stent implantation on MACE were studied.
Results: Age, DM, hypertension, and hyperlipidemia did not significantly affect the incidence of MACE (P>0.05). However, time from the start of symptoms onset to admission (P=0.04, OR=1.278), time from failure of reperfusion to start of PCI (P=0.038, OR=1.382), TIMI flow grade 0 at time of diagnostic coronary angiography (P=0.035, OR=3.75), and type of stent implantation (P=0.003, OR= 2.548) were independent risk factors associated with MACE post PCI, also good LVEF had significant relations with less incidence of MACE (P=0.02,OR=0.93).
Conclusion: Prolonged time from symptoms onset to admission, prolonged time from failure of reperfusion to start of PCI, TIMI flow grade 0 at time of diagnostic CA, BMS (Bare Metal Stent) implantation and LVEF are risk factors of MACE after rescue PCI.