Abstract | BACKGROUND: OBJECTIVE: The acute myocardial infarction (AMI) registration study in Xinjiang, China, is a real-world clinical trial (retrospective cohort study) that includes hospitalized patients. The purpose of this study was to compare delayed PCI and medication therapy beyond the recommended time window of 12 h after the onset of symptoms on the outcomes of STEMI patients. METHODS AND RESULTS: From May 2012 to December 2015, a total of 1072 STEMI patients received delayed PCI (n=594) or standard medication therapy (MT) (n=478) more than 12 h after the onset of symptoms. The number of all-cause deaths in the delayed PCI group and that in the MT group were 55 (9.3%) and 138 (28.9%), respectively, and a significant difference between the groups was indicated for this variable (P<0.001). The number of cardiac deaths in the delayed PCI group and that in the medication therapy group were 47 (7.9%) and 120 (25.1%), respectively, and a significant difference between the groups was indicated for this variable (P<0.001). We also found that the MACE incidence in the delayed PCI group was significantly higher than it was in the MT group (32.2% versus 43.5%, P<0.001). Propensity score matching (PSM) analyses remained significant differences between the delayed PCI group and the MT group, respectively, in all-cause deaths (9.3% versus 25.8%, P<0.001) and cardiac death (8.7% versus 21.6%, P<0.001). CONCLUSION: Compared to medication therapy, PCI for STEMI delayed beyond 12 h after the onset of symptoms can better reduce mortality and the incidence of MACEs. TRIAL REGISTRATION: This study is registered with the following: Trial Registration: clinicaltrials.gov; Identifier: NCT02737956.
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Authors | Wen-Juan Xiu, Hai-Tao Yang, Ying-Ying Zheng, Yi-Tong Ma, Xiang Xie |
Journal | Journal of interventional cardiology
(J Interv Cardiol)
Vol. 2019
Pg. 2387929
( 2019)
ISSN: 1540-8183 [Electronic] United States |
PMID | 31772517
(Publication Type: Journal Article, Multicenter Study, Observational Study)
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Copyright | Copyright © 2019 Wen-Juan Xiu et al. |
Chemical References |
- Heparin, Low-Molecular-Weight
- Platelet Aggregation Inhibitors
- Platelet Glycoprotein GPIIb-IIIa Complex
- Clopidogrel
- Aspirin
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Aspirin
(therapeutic use)
- China
(epidemiology)
- Clopidogrel
(therapeutic use)
- Female
- Heparin, Low-Molecular-Weight
(therapeutic use)
- Humans
- Male
- Middle Aged
- Percutaneous Coronary Intervention
- Platelet Aggregation Inhibitors
(therapeutic use)
- Platelet Glycoprotein GPIIb-IIIa Complex
(antagonists & inhibitors)
- ST Elevation Myocardial Infarction
(mortality, therapy)
- Time-to-Treatment
- Young Adult
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