title: Benefit of percutaneous coronary intervention in early latecomers with acute ST-segment elevation myocardial infarction.
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.
authors: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors: Doo Sun
authors: DS
authors: Sim
authors: Myung-Ho
authors: MH
authors: Jeong
authors: Youngkeun
authors: Y
authors: Ahn
authors: Young Jo
authors: YJ
authors: Kim
authors: Shung Chull
authors: SC
authors: Chae
authors: Taek Jong
authors: TJ
authors: Hong
authors: In Whan
authors: IW
authors: Seong
authors: Jei Keon
authors: JK
authors: Chae
authors: Chong Jin
authors: CJ
authors: Kim
authors: Myeong Chan
authors: MC
authors: Cho
authors: Seung-Woon
authors: SW
authors: Rha
authors: Jang Ho
authors: JH
authors: Bae
authors: Ki Bae
authors: KB
authors: Seung
authors: Seung Jung
authors: SJ
authors: Park
mesh_terms: D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D005343:Fibrinolytic Agents