Author/Authors :
Sim، نويسنده , , Doo Sun and Jeong، نويسنده , , Myung Ho and Ahn، نويسنده , , Youngkeun and Kim، نويسنده , , Young Jo and Chae، نويسنده , , Shung Chull and Hong، نويسنده , , Taek Jong and Seong، نويسنده , , In Whan and Chae، نويسنده , , Jei Keon and Kim، نويسنده , , Chong-Jin and Cho، نويسنده , , Myeong Chan and Rha، نويسنده , , Seung-Woon and Bae، نويسنده , , Jang Ho and Seung، نويسنده , , Ki Bae and Park، نويسنده ,
Abstract :
The clinical benefit of percutaneous coronary intervention (PCI) is controversial in stable early latecomers with ST-segment elevation myocardial infarction (STEMI). We evaluated the efficacy of PCI in 2,344 stable patients with STEMI presenting 12 to 72 hours after symptom onset. Patients who had impaired hemodynamics or who had undergone fibrinolysis or immediate or urgent PCI were excluded. The patients were divided into the PCI group (n = 1,889) and medical treatment group (n = 455). The 12-month clinical outcome was compared between the 2 groups. After adjustment using propensity score stratification, the PCI group had lower mortality (3.1% vs 10.1%; hazard ratio 0.31; 95% confidence interval 0.20 to 0.47; p <0.001) and a lower incidence of composite death/myocardial infarction (3.8% vs 11.2%; hazard ratio 0.36; 95% confidence interval 0.25 to 0.53; p <0.001) at 12 months. The benefit of PCI was consistent across all subgroups, including patients presenting without chest pain. In conclusion, in stable patients with STEMI presenting 12 to 72 hours after symptom onset, PCI was associated with significant improvement in the 12-month clinical outcome.
