Korean Circ J.  2008 Jan;38(1):23-28. 10.4070/kcj.2008.38.1.23.

Prognosis According to the Timing of Percutaneous Coronary Intervention in an Acute Non-ST Segment Elevation Myocardial Infarction

• An SG
• Park TI
• Lee SH
• Jang HH
• Lee DW
• Ha JK
• Lee HC
• Kim J
• Kim JH
• Chun KJ
• Hong TJ
• Shin YW

• KMID: 2225870
• DOI: http://doi.org/10.4070/kcj.2008.38.1.23

Abstract

BACKGROUND AND OBJECTIVES
An early invasive strategy with coronary angiography and revascularization is currently the recommended treatment for patients at high risk with an acute non-ST-segment elevation myocardial infarction (NSTEMI). In this early invasive strategy, percutaneous coronary intervention (PCI) is generally recommended within 48 hours, but there is little data on earlier intervention in intermediate risk patients.
SUBJECTS AND METHODS
We studied retrospectively the past medical records of 118 patients at intermediate risk that were admitted at Pusan National University Hospital and were stratified by the time interval from chest pain onset to PCI (Group I: <24 hr; Group II: 24-48 h; Group III: >48 h). Clinical outcomes were evaluated in terms of in-hospital and 12 months follow-up of a major adverse cardiac event (MACE).
RESULTS
Baseline characteristics were not different statistically among the three groups, except for the use of tirofiban. There were no in-hospital deaths or myocardial infarctions (MI) in Group I and Group II patients, but there were three cases of in-hospital deaths in Group III patients. The incidence of a 12-month MACE was 0% in Group I patients, 6.7% (one revascularization) in Group II patients and 17.1% (3 deaths, 3 MIs, 7 revascularizations) in Group III patients (p=0.043).
CONCLUSION
In acute NSTEMI, the incidence of a 12-month MACE was lower in the intermediate risk group when PCI was performed in the early period. Early PCI could be recommended in acute NSTEMI on the basis of the status of individual patients.

Keyword

Myocardial infarction; Angioplasty, transluminal, percutaneous coronary; Early intervention

MeSH Terms

Angioplasty, Balloon, Coronary
Chest Pain
Coronary Angiography
Early Intervention (Education)
Follow-Up Studies
Humans
Incidence
Medical Records
Myocardial Infarction
Percutaneous Coronary Intervention
Prognosis
Retrospective Studies
Tyrosine
Tyrosine

Figure

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  Fig. 1 In-hospital major adverse cardiovascular events (MACE).

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  Fig. 2 Major adverse cardiac events (MACE) free survival curve.

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