Percutaneous Myocardial Revascularization in Late-Presenting Patients With STEMI - Archive ouverte HAL Access content directly
Journal Articles Journal of the American College of Cardiology Year : 2021

Percutaneous Myocardial Revascularization in Late-Presenting Patients With STEMI

Etienne Puymirat
  • Function : Author
  • PersonId : 995758
Guillaume Cayla
  • Function : Author
  • PersonId : 1037375
Nadia Aissaoui
  • Function : Author
  • PersonId : 1108679
Didier Blanchard
  • Function : Author
François Schiele
  • Function : Author
  • PersonId : 1033120
Nicolas Danchin
  • Function : Author
  • PersonId : 1026716

Abstract

Background: The optimal management of patients with ST-segment elevation myocardial infarction (STEMI) presenting late->12 hours following symptom onset-is still under debate. Objectives: The purpose of this study was to describe characteristics, temporal trends, and impact of revascularization in a large population of latecomer STEMI patients. Methods: The authors analyzed the data of 3 nationwide observational studies from the FAST-MI (French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction) program, conducted over a 1-month period in 2005, 2010, and 2015. Patients presenting between 12 and 48 hours after symptom onset were classified as latecomers. Results: A total of 6,273 STEMI patients were included in the 3 cohorts, 1,169 (18.6%) of whom were latecomers. After exclusion of patients treated with fibrinolysis and patients deceased within 2 days after admission, 1,077 patients were analyzed, of whom 729 (67.7%) were revascularized within 48 hours after hospital admission. At 30-day follow-up, all-cause death rate was significantly lower among revascularized latecomers (2.1% vs 7.2%; P < 0.001). After a median follow-up of 58 months, the rate of all-cause death was 30.4 (95% CI: 25.7-35.9) per 1,000 patient-years in the revascularized latecomers group vs 78.7 (95% CI: 67.2-92.3) per 1,000 patient-years in the nonrevascularized latecomers group (P < 0.001). In multivariate analysis, revascularization of latecomer STEMI patients was independently associated with a significant reduction of mortality occurrence during follow-up (HR: 0.65 [95% CI: 0.50-0.84]; P = 0.001). Conclusions: Coronary revascularization of latecomer STEMI patients is associated with better short and long-term clinical outcomes.
Fichier principal
Vignette du fichier
S0735109721057764.pdf (324.59 Ko) Télécharger le fichier
Origin Files produced by the author(s)

Dates and versions

hal-03626432 , version 1 (16-10-2023)

Licence

Identifiers

Cite

Frédéric Bouisset, Edouard Gerbaud, Vincent Bataille, Pierre Coste, Etienne Puymirat, et al.. Percutaneous Myocardial Revascularization in Late-Presenting Patients With STEMI. Journal of the American College of Cardiology, 2021, 78 (13), pp.1291-1305. ⟨10.1016/j.jacc.2021.07.039⟩. ⟨hal-03626432⟩
73 View
66 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More