Logo

American Heart Association

  8
  0


Final ID: Sa4027

Impact of Timing on Outcomes in Rescue PCI for STEMI: Early vs. Late Intervention

Abstract Body (Do not enter title and authors here):
Introduction:
American guidelines recommend rescue PCI within 3 to 24 hours after failed fibrinolysis in patients with ongoing ischemia, hemodynamic instability, or other high-risk features. Given the large areas covered by relatively few centers, rescue PCI can be delayed.
Aims
This abstract aims to compare complications in patients undergoing early rescue PCI (within 6 hours post-thrombolysis) versus late rescue PCI (more than 6 hours post-thrombolysis).
Methods
A prospective registry was conducted, patients over 18 years with diagnosis of STEMI undergoing rescue PCI (reperfusion therapy when thrombolysis has failed) in a tertiary cardiology center in Mexico from august of 2023 to april of 2024 were included. We divided patients into two groups, the ones who received early rescue PCI (within 6 hours post-thrombolysis) versus late rescue PCI (more than 6 hours post-thrombolysis).
Results
109 patients who received late Rescue PCI and 56 patients who received early Rescue PCI were included. Baseline characteristics in patients undergoing Rescue PCI before and after 6 hours are presented in table 1. Patients who underwent late rescue PCI showed worsening heart failure (KK: Killip Kimball IV) 14.2% vs 9.1% (p= 0.319.). The Major adverse cardiovascular events (MACE) reported with statistical significance are angina (p value 0.048) and especially renal failure (p= 0.016). The survival rate was significantly higher when the patient entered rescue PCI after 6 hours 95.4% vs 89.2% (p = 0.023).
Conclusion:
Although no specific time frame has been set for rescue PCI, patients who underwent to rescue PCI within six hours showed worsening outcomes such as angina and renal failure, possibly due to higher KK grades, the onset of cardiogenic shock, and lower survival rates. A major limitation of our study was the small sample size, which restricted comparisons of MACE with other outcomes. This limitation is expected to improve as our database expands. Despite these findings, it is essential to base the decision to perform a rescue PCI on the patient's initial condition upon arrival at a capable PCI center.
  • Adib Gracia, Anna Elisa  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Ontiveros Mercado, Heriberto  ( Hospital Juarez de Mexico , Mexico , Mexico )
  • Arias, Alexandra  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Santiago Hernández, Alberto  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Neri Bale, Raul Rodrigo  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Cuellar, Jorge  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Gonzalez Macedo, Eder  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Diaz, Braiana  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Latapi Ruiz Esparza, Ximena  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Garcia Villarejo, Mariana  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Araiza, Diego  ( National Institute of Cardiology Ignacio Chávez , Mexico city , Mexico )
  • Author Disclosures:
    Anna Elisa Adib Gracia: DO NOT have relevant financial relationships | Heriberto Ontiveros Mercado: DO NOT have relevant financial relationships | Alexandra Arias: DO have relevant financial relationships ; Speaker:Boehringer:Active (exists now) ; Speaker:bayer:Active (exists now) ; Speaker:bayer:Active (exists now) ; Speaker:servier:Active (exists now) ; Speaker:servier:Active (exists now) ; Speaker:roche:Active (exists now) ; Speaker:roche:Active (exists now) ; Speaker:novartis:Active (exists now) ; Speaker:novartis:Active (exists now) | Alberto Santiago Hernández: DO NOT have relevant financial relationships | Raul Rodrigo Neri Bale: DO NOT have relevant financial relationships | Jorge Cuellar: DO NOT have relevant financial relationships | Eder Gonzalez Macedo: DO NOT have relevant financial relationships | Braiana Diaz: DO NOT have relevant financial relationships | Ximena Latapi Ruiz Esparza: DO NOT have relevant financial relationships | Mariana Garcia Villarejo: DO NOT have relevant financial relationships | Diego Araiza: DO have relevant financial relationships ; Speaker:Boehringer Ingelheim:Active (exists now) ; Speaker:Viatris:Active (exists now) ; Speaker:Astra Zeneca:Active (exists now) ; Speaker:Novartis:Active (exists now) ; Speaker:Novo Nordisk:Active (exists now) ; Speaker:Adium:Active (exists now)
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

All Things STEMI

Saturday, 11/16/2024 , 02:00PM - 03:00PM

Abstract Poster Session

More abstracts on this topic:
AI-Enhanced Recognition of Occlusion in Acute Coronary Syndrome (AERO-ACS): A Retrospective Review

Choi James, Torelli Vincent, Diaz Sara, Vaish Esha, Katic Luka, Nagourney Alex, Khan Zara, Silverman Alex, Farhan Serdar

Aggressive LDL cholesterol lowering post ACS with triple combination therapy: Insights from the multicentric LAI-REACT study

Puri Raman, Mahajan Kunal, Agarwala Rajeev, Gupta Ashu, Batra Aditya, Khan Aziz, Vijan Vinod, Sharma Jai Bharat, Himral Surender

More abstracts from these authors:
Mechanism of Acute Mitral Regurgitation in Patients with Acute Coronary Syndrome As A Predictor Of Mortality

Neri Bale Raul Rodrigo, Arias-mendoza Alexandra, Amaro Palomo Eder Jonathan, Gonzalez Macedo Eder, Latapi Ruiz Esparza Ximena, Arias-escarpulli Romeo, Garcia Villarejo Mariana, Santiago Hernández Alberto, Araiza Diego, Gopar-nieto Rodrigo

PORTAL VEIN PULSATILITY INDEX, INDEPENDENT OF INFERIOR VENA CAVA DILATATION, PREDICTS ACUTE KIDNEY INJURY IN PATIENTS WITH ACUTE HEART FAILURE

Gonzalez Macedo Eder, Arias-mendoza Alexandra, Araiza Diego, Latapi Ruiz Esparza Ximena, Hernandez-pastrana Sarai, Diaz Braiana, Garcia Villarejo Mariana, Neri Bale Raul Rodrigo, Santiago Hernández Alberto, Gopar-nieto Rodrigo, Sierra Lara Martinez Jorge Daniel

You have to be authorized to contact abstract author. Please, Login
Not Available