The following is a summary of “Efficacy and Safety of the Pharmacoinvasive Strategy Compared With Primary Percutaneous Coronary Intervention in Patients Initially Presenting to Hospital Centers Without Capacity for Coronary Intervention,” published in the November 2023 issue of Cardiology by Robles-Ledesma et al.
Primary PCI (pPCI) is the gold standard treatment for STEMI, but its real-world feasibility is often limited. Researchers aimed to compare the effectiveness of a pharmacoinvasive strategy to primary PCI in non-PCI centers.
The study’s consecutive STEMI patients(pts) were treated within 12 hours of symptom onset. Patients were assigned to either a pharmacoinvasive approach or were directed for pPCI.The primary composite endpoint was cardiovascular death, recurrent myocardial infarction, or congestive heart failure cardiogenic shock at 30-day follow-up.
About 634 pts were included, 61.3% underwent the pharmacoinvasive strategy, and 38.6% were referred for pPCI. The mean age was 58.3 years (+/-10), with the majority being men (85.3%). Compared to those transferred for pPCI, the pharmacoinvasive approach demonstrated a significant 40% risk reduction in the primary endpoint beyond 30 days, as indicated by HR of 0.60 (95% CI 0.39-0.94, P= 0.02). This reduction was primarily attributed to a significant decrease in the risk of heart failure by 43% (HR 0.57, 95% CI 0.35-0.93, P= 0.025).
The study found that the pharmacoinvasive strategy significantly reduced the risk of major adverse cardiac events at 30 days compared to primary PCI referral.
Source: abstractsonline.com/pp8/#!/10871/presentation/8357
