The Clinical Outcomes of Primary Angioplasty in Hospitalized Patients with ST-Segment Elevation Acute Myocardial Infarction Were Investigated at Imam Reza Hospital from 1399 to 1401

Document Type : Original Article

Authors

1 Department of Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Medical Student, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Ischemic heart disease (IHD) is a major global health concern with significant implications for patient mortality and life expectancy. Effective management of IHD heavily relies on vascular reconstruction procedures, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).
Material and Method: This study was conducted at Imam Reza Hospital, evaluating 103 patients with myocardial infarction with ST elevation (MI-STE) who underwent PCI. The cohort comprised 84 men and 19 women across varying age ranges. A subset of these patients had a history of CABG, addiction, or a family history of heart disease. The study focused on the types of stents used, with Supraflex and Xience being the most common, primarily in lengths of ≤20 mm and diameters of 2.75 mm. Post-PCI complications were also assessed, including hematoma at the angiography site, rehospitalization, coronary artery revascularization, contrast-induced nephropathy (CIN), no reflow, in-stent restenosis (ISR), coronary artery dissection, and cardiogenic shock.
Result and Conclusion: The overall population experienced a low mortality rate of 1.9%. Notably, cardiogenic shock was significantly associated with mortality, posing a 100-fold increased risk. This study underscores the importance of monitoring and managing post-PCI complications to improve patient outcomes and reduce mortality in individuals with IHD. Further research is warranted to explore preventive strategies and optimize treatment approaches for this patient population.

Keywords

References

  1. Khan MA, Hashim MJ, Mustafa H, Baniyas MY, Al Suwaidi SK, AlKatheeri R, et al. Global epidemiology of ischemic heart disease: results from the global burden of disease study. Cureus. 2020 Jul 23;12(7).
  2. Park DW, Kim YH, Yun SC, Kang SJ, Lee SW, Lee CW, et al. Comparison of zotarolimus-eluting stents with sirolimus-and paclitaxel-eluting stents for coronary revascularization: the ZEST (comparison of the efficacy and safety of zotarolimus-eluting stent with sirolimus-eluting and paclitaxel-eluting stent for coronary lesions) randomized trial. Journal of the American College of Cardiology. 2010 Oct 5;56(15):1187-95.
  3. Nowbar AN, Gitto M, Howard JP, Francis DP, Al-Lamee R. Mortality from ischemic heart disease: Analysis of data from the World Health Organization and coronary artery disease risk factors From NCD Risk Factor Collaboration. Circulation: cardiovascular quality and outcomes. 2019 Jun;12(6):e005375.
  4. Osho A, Fernandes MF, Poudel R, De Lemos J, Hong H, Zhao J, et al. Race-based differences in ST-segment–elevation myocardial infarction process metrics and mortality from 2015 through 2021: an analysis of 178 062 patients from the American Heart Association get with the guidelines–coronary artery disease registry. Circulation. 2023 Jul 18;148(3):229-40.
  5. Timmis A, Townsend N, Gale CP, Torbica A, Lettino M, Petersen SE, et al. European Society of Cardiology: cardiovascular disease statistics 2019. European heart journal. 2020 Jan 1;41(1):12-85.
  6.  Varaei S, Shamsizadeh M, Kolahdozan S, Oshvandi K, Dehghani A, Parviniannasab AM, et al. Randomized controlled trial of a peer based intervention on cardiac self-efficacy in patients undergoing coronary artery bypass graft surgery: a 3-year follow-up results. International Journal of Health Studies (Undergoing change to Shahroud Journal of Medical Sciences). 2016 Apr 17:14-9.
  7. Shafipour V, Shafipour L, Jafari H. The Effect of the cardiac rehabilitation program on the quality of life in patients with myocardial infarction.
  8. Ghashghaei FE, Sadeghi M, Marandi SM, Ghashghaei SE. Exercise-based cardiac rehabilitation improves hemodynamic responses after coronary artery bypass graft surgery. ARYA atherosclerosis. 2012;7(4):151.
  9. KARIMI ZA, Naghiei MR. Prevalence of risk factors of coronary heart disease and effect of life-style modification guides.
  10. Allahbakhshian A, Hasankhani H, Mohammadi E, Zamanzadeh V, Ghaffari S. Second life after angioplasty: a qualitative study. Cardiovasc Nurs J. 2014;2(4):52-63.
  11. Ullah M, Wahab A, Khan SU, Zaman U, ur Rehman K, Hamayun S, et al. Stent as a novel technology for coronary artery disease and their clinical manifestation. Current Problems in Cardiology. 2023 Jan 1;48(1):101415.
  12. Patel DB, Shah R, Jovin IS. Improving outcomes of percutaneous coronary interventions in patients with stable ischemic heart disease. Journal of Thoracic Disease. 2020 Apr;12(4):1740.
  13. Nikpayma N, Esmaeili M, Azargoshasb Y, Taghavi T. The effects of self-management on coping strategies in patients after angioplasty. Iranian Journal of Psychiatric Nursing. 2017 Aug 10;5(3):29-36.
  14. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. The lancet. 2003 Jan 4;361(9351):13-20.
  15. Ronner E, Boersma E, Laarman GJ, Somsen GA, Harrington RA, Deckers JW, et al. Early angioplasty in acute coronary syndromes without persistent ST-segment elevation improves outcome but increases the need for six-month repeat revascularization: an analysis of the PURSUIT Trial. Journal of the American College of Cardiology. 2002 Jun 19;39(12):1924-9.
  16. Pedersen F, Butrymovich V, Kelbæk H, Wachtell K, Helqvist S, Kastrup J, et al. Short-and long-term cause of death in patients treated with primary PCI for STEMI. Journal of the American College of Cardiology. 2014 Nov 18;64(20):2101-8.
  17. Halkin A, Singh M, Nikolsky E, Grines CL, Tcheng JE, Garcia E, et al. Prediction of mortality after primary percutaneous coronary intervention for acute myocardial infarction: the CADILLAC risk score. Journal of the American College of Cardiology. 2005 May 3;45(9):1397-405.
  18. Zijlstra F, Patel A, Jones M, Grines CL, Ellis S, Garcia E, et al. Clinical characteristics and outcome of patients with early (< 2h), intermediate (2–4h) and late (> 4h) presentation treated by primary coronary angioplasty or thrombolytic therapy for acute myocardial infarction. European Heart Journal. 2002 Apr 1;23(7):550-7.
  19. Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, et al. Optimal medical therapy with or without PCI for stable coronary disease. New England journal of medicine. 2007 Apr 12;356(15):1503-16.
  20. Qavam S, Ahmadi MH, Tavan H, Yaghobi M, Mehrdadi A. High-sensitive C-reactive protein in patients with acute coronary syndrome in statin therapy and its impact on prognosis. Tehran University Medical Journal. 2016;74(4):289-96.
  21. QAVAM SM, SHARIFI A, NOROZI S, TAVAN H. The relationship between C-reactive protein ultra sensitive (HS-CRP) with diastolic heart function in patients with primary hypertension who were referred to specialized clinics of the city of Ilam in 2013.
  22. Serruys PW, Unger F, Sousa JE, Jatene A, Bonnier HJ, Schönberger JP, et al. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease. New England Journal of Medicine. 2001 Apr 12;344(15):1117-24.
  23. Trialists FT. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. The lancet. 1994 Feb 5;343(8893):311-22.
  24. De Luca G, Dirksen MT, Spaulding C, Kelbæk H, Schalij M, Thuesen L, et al. Impact of diabetes on long-term outcome after primary angioplasty: insights from the DESERT cooperation. Diabetes Care. 2013 Apr 1;36(4):1020-5.
  25. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG, Holmes DR, et al. 2014 AHA/ACC guideline for the management of patients with non–ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American college of cardiology. 2014 Dec 23;64(24):2645-87.
  26. Mariani J, Macchia A, De Abreu M, Gonzalez Villa Monte G, Tajer C. Multivessel versus single vessel angioplasty in non-ST elevation acute coronary syndromes: a systematic review and metaanalysis. PLoS One. 2016 Feb 17;11(2):e0148756..
  27. Head SJ, Milojevic M, Daemen J, Ahn JM, Boersma E, Christiansen EH, et al. Stroke rates following surgical versus percutaneous coronary revascularization. Journal of the American College of Cardiology. 2018 Jul 24;72(4):386-98.
Journal of Cardio-Thoracic Medicine
Volume 13, Issue 1
March 2025
Pages 1476-1484

Files

Share

How to cite

Statistics