A comparison of rescue and primary percutaneous coronary interventions for acute myocardial infarction: a multicenter registry report of 9,371 patients.
OBJECTIVE
To perform a comparative analysis of in-hospital results obtained from AMI patients who underwent rescue or primary PTCA.


METHODS
From the Brazilian Interventional National Registry (CENIC), we selected all consecutive patients who underwent a percutaneous coronary intervention for myocardial infarction (< 24 hours), between 1997 and 2000, analyzing those undergoing a rescue (n=840) or a primary (n=8,531) procedure, and comparing their in-hospital results.


RESULTS
Rescue patients were significantly younger males with anterior wall infarctions, associated with left ventricular dysfunction, but had less multivessel disease, compared with those treated with primary intervention. Coronary stents were implanted in at similar rates (56.9% vs. 54.9%; P=0.283). Procedural success were lower for rescue cases (88.1% vs. 91.2%; P<0.001), with higher mortality (7.4% vs. 5.6%; P=0.034), compared with the primary intervention group; target vessel revascularization (< or =0.5%), emergency bypass surgery (< or =0.3%) and reinfarction (< or =2.6%) rates were similar for both strategies. Multivariate analysis identified the rescue procedure as a predictor of in-hospital death [OR(CI=95%) = 1.60 (1.17-2.19); P=0.003].


CONCLUSIONS
Patients who underwent a rescue coronary intervention had higher in-hospital death rates compared with those who underwent a primary coronary intervention.
Mattos
Luiz Alberto
LA
Instituto Dante Pazzanese de Cardiologia e Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista, São Paulo, SP, Brazil. pivmattos@uol.com.br
Sousa
Amanda G M R
AG
Pinto
Ibraim M F
IM
Silva
Expedito R
ER
Carneiro
José Klauber
JK
Sousa
J Eduardo
JE
Mangione
José Armando
JA
Caramori
Paulo
P
Lima
Valter
V
Bueno
Ronaldo L
RL
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D015425:Myocardial Reperfusion; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016879:Salvage Therapy / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors