In-hospital Major Cardiovascular Events between STEMI Receiving Thrombolysis Therapy and Primary PCI
ABSTRACT: to compare the
in-hospital major cardiovascular events between thrombolysis therapy and
primary percutaneous coronary intervention (PCI) in patients with ST-elevation
acute myocardial infarction (STEMI. Methods: the study design is retrospective
cohort. Medical record of patients with STEMI onset <12 hour receiving thrombolysis
treatment or primary PCI in Dr. Sardjito Hospital Yogyakarta between January
2008 and March 2010 are evaluated. The primary outcome is major cardiovascular
events which comprise cardiovascular death, reinfarction and stroke during
hospitalisation. The secondary outcomes are post infarction angina pectoris,
heart failure, cardiogenic shock and bleeding. Results: among 78 patients with
thrombolysis and 53 patients with primary PCI, in-hospital major cardiovascular
events do not differ signifcantly (10.3% versus 9.4%; RR 1.09, 95%CI 0.33-3.55;
p=0.87). Post infarction angina pectoris is 7% versus 3.8% (RR 2.51, 95%CI
0.50-12.60; p=0.24). The incidence of heart failure is signifcantly higher in
thrombolysis (17.9% versus 5.7%; RR 3.64, 95%CI 0.99-13.38; p=0.04), primary
PCI reduces 68.1% relative risk to develop acute heart failure in STEMI. The
incidence of cardiogenic shock is not different. Major and minor bleeding do
not differ signifcantly either. Conclusion: the in-hospital major
cardiovascular events between STEMI receiving thrombolysis therapy and primary
PCI is not signifcantly different. Heart failure is signifcantly higher in
thrombolysis therapy and the primary PCI reduces the risk.
Author: Irsad A. Arso, Budi Y.
Setianto, Nahar Taufq, Anggoro B. Hartopo
Journal Code: jpkedokterangg140278
