Comparative Study between Safety and Efficacy of Pharmacoinvasive Strategy and Primary Percutaneous Coronary Angioplasty in Patients Presenting by Acute ST Segment Elevation Myocardial Infarction

SAMIA M. SHARAF EL-DIN, M.D., AHMED G. SHAHIN, M.Sc.;; AYMAN A. AL-SHEIKH, M.D., YASSER H. EL-BARBARY, M.D.;

doi:10.21608/mjcu.2019.52527

Comparative Study between Safety and Efficacy of Pharmacoinvasive Strategy and Primary Percutaneous Coronary Angioplasty in Patients Presenting by Acute ST Segment Elevation Myocardial Infarction

Document Type : Original Article

Authors

The Department of Cardiology, Faculty of Medicine, Tanta University

10.21608/mjcu.2019.52527

Abstract

Abstract
Background: Ischemic heart disease is considered the most common cause of death worldwide. Reperfusion treatment in acute myocardial infarction aims at early and sustained reperfusion of the myocardium at risk. Traditionally reperfusion can be obtained by thrombolysis or by primary Percutaneous Coronary Intervention (pPCI).
Aim of Study: Study and assess the safety and efficacy of a Pharmacoinvasive (PI) strategy compared with (pPCI) strategy in ST Segment Elevation Myocardial Infarction (STEMI) management.
Patients and Methods: Comparing clinical results regard-ing mortality, Major Adverse Cardiac Events (MACE) and Left Ventricular (LV) systolic function by echocardiography during hospital admission and 30 days follow-up, in 200 patients presenting with STEMI.
Results: During hospital admission, the composite of death/Congestive Heart Failure (CHF) in patients treated with PI strategy versus the group managed by pPCI occurred in 4% versus 7% (p=0.352); 9% versus 13% (p=0.366) respec-tively. No cases of re-infarction recorded during hospital admission.
After 30-days follow-up, the composite of death/congestive heart failure/re-infarction in PI and pPCI arms occurred in 3% versus 3% (p=0.635); 8% versus 3% (p=0.211); 0% versus 3% (p=0.139) respectively.
Conclusion: In daily clinical practice pharmacoinvasive, strategy is considered safe alternative to primary PCI. Espe-cially considering logistical issues and delay in the initiation of management of STEMI.

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