Browse by author
Lookup NU author(s): Dr Javed Ahmed,
Professor Ioakim Spyridopoulos,
Dr Alan Bagnall,
Dr Mohaned Egred
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Aims To assess the impact of the time of primary percutaneous coronary intervention (PPCI) on in-hospital and long-term all-cause mortality in ST-segment elevation myocardial infarction (STEMI). Methods and results The study retrospectively analyses the prospectively collected data on 2571 consecutive PPCI-treated STEMI patients between March 2008 and June 2011. Of these, 1036 patients (40.3%) underwent PPCI during a weekday between 08: 00 and 18: 00 (routine-hours group) and 1535 patients (59.7%) underwent PPCI on a weekday between 18: 00 and 08: 00 or a weekend (out-of-hours group). Compared with the routine-hours group, the out-of-hours group had a lower mean age, fewer patients with previous angina, longer call-to-hospital time, and fewer multivessel PCI. The overall in-hospital mortality rate was 4.5% with no significant difference [0.2%, 95% confidence interval (CI): -1.4 to 1.9%] between the routine-hours group (4.3%) and the out-of-hours group (4.6%) (adjusted odds ratio: 1.33, 95% CI: 0.73-2.40, P = 0.35). During a mean follow-up period of 560 days, 295 patients (11.5%) died, 12.2% in the routine-hours group and 11.0% in the out-of-hours group (difference of -0.1%, 95% CI: -0.4 to 0.2%). In the multiple Cox proportional hazards model, there was no difference in mortality between the two groups (adjusted hazard ratio: 1.09, 95% CI: 0.82-1.46, P = 0.57). Similarly, no increase in mortality was seen in patients who underwent PPCI later at night (22:00-06:00). Conclusion This study of real-world, unselected STEMI patients demonstrates that in a large, well-staffed centre, PPCI outside routine-working hours is safe with no difference in outcome of in-hospital and long-term mortality compared with PPCI during routine-working hours.
Author(s): Noman A, Ahmed JM, Spyridopoulos I, Bagnall A, Egred M
Publication type: Article
Publication status: Published
Journal: European Heart Journal
Print publication date: 04/09/2012
ISSN (print): 0195-668X
ISSN (electronic): 1522-9645
Publisher: Oxford University Press
Altmetrics provided by Altmetric