In Hospital Outcomes in Patients with Non-ST Elevated Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Mahzaib Raza; Abdul Manan Bari; Qaiser Saleem; Ijaz ul Haq; Laiba Ajmal

doi:10.70749/ijbr.v2i02.120

Authors

Mahzaib Raza Department of Cardiology, P.A.E.C General Hospital, Islamabad, Pakistan
Abdul Manan Bari Department of Cardiology, P.A.E.C General Hospital, Islamabad, Pakistan
Qaiser Saleem Department of Cardiology, P.A.E.C General Hospital, Islamabad, Pakistan
Ijaz ul Haq Department of Cardiology, P.A.E.C General Hospital, Islamabad, Pakistan
Laiba Ajmal Department of Cardiology, MTI Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v2i02.120

Keywords:

NSTEMI, PCI, in-hospital outcomes, Pakistan, cardiovascular

Abstract

Objective: To evaluate the in-hospital outcomes of patients with non-ST elevated myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI).

Methodology: A total of 200 NSTEMI patients who underwent PCI were included in this prospective observational study. The study was conducted in the Department of Cardiology, Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad, Pakistan, from January to June 2024.

Patient demographics, clinical characteristics, and procedural outcomes were analyzed. The primary endpoints were the success rate of PCI and in-hospital mortality. Secondary measures included door-to-balloon time and the relationship between comorbidities such as hypertension and diabetes. Data were analyzed using chi-squared tests and descriptive statistics.

Results: The PCI success rate was 87.5%, with 12.5% of patients experiencing complications. The in-hospital mortality rate was 4.5%. The mean door-to-balloon time was 82.33 ± 9.93 minutes, with no significant difference between successful and complicated procedures. The chi-squared test revealed no statistically significant association between hypertension and diabetes (p = 0.4167). The results demonstrate that PCI for NSTEMI patients at this facility is highly effective and comparable to international outcomes.

Conclusion: PCI is a successful and life-saving intervention for NSTEMI patients, with a high procedural success rate and low in-hospital mortality. This study provides essential data for NSTEMI management in Pakistan, filling a gap in local literature and supporting timely PCI as a standard of care to improve patient outcomes.

Downloads

Download data is not yet available.

References

Baumann AAW, Mishra A, Worthley MI, Nelson AJ, Psaltis PJ. management of multivessel coronary artery disease in patients with non-st-elevation myocardial infarction: a complex path to precision medicine. Ther Adv Chronic Dis 2020;11. https://doi.org/10.1177/2040622320938527.

Igbinomwanhia E, Sanchez Nadales A, Grimm RA, Griffin BP, Kapadia SR, Xu B. abstract 14255: contemporary characteristics and management of patients aged ≥ 80 years presenting with non-st elevation myocardial infarctions in the united states: a nationwide inpatient sample cohort study. Circulation 2020;142. https://doi.org/10.1161/circ.142.suppl_3.14255.

Muhammad Owais, Amjad Ali, Muhammad Adeel, Ambreen Haider, Ashok Kumar, Marvi Nawaz. in hospital outcome among smoker and nonsmoker patients presented with st-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Ann PIMS-Shaheed Zulfiqar Ali Bhutto Med Univ 2023;19:10–5. https://doi.org/10.48036/apims.v19i1.727.

Fazeel HM, Malik SU, Ranjha S, Yousaf A, Yousaf H, Salah Ud Din E. abstract 16311: differential outcomes of primary percutaneous coronary intervention compared to medical management alone for very elderly patients with st-elevation and non-st-elevation myocardial infarctions - a systematic review and meta-analysis. Circulation 2023;148. https://doi.org/10.1161/circ.148.suppl_1.16311.

Van Den Broek WW, Gimbel ME, Hermanides RS, Runnet C, Storey RF, Austin D, et al. treatment and prognosis of elderly patients with non-st-elevation myocardial infarction. Eur Heart J 2022;43. https://doi.org/10.1093/eurheartj/ehac544.2541.

Shah AA, Shah SDA, Zafar A, Shaikh GA, Aslam M, Kumar S, et al. in-hospital outcomes of primary percutaneous coronary intervention in patients presenting with acute st elevation myocardial infarction in a tertiary care hospital in karachi. J Pharm Res Int 2022:1–8. https://doi.org/10.9734/jpri/2022/v34i30A36061.

Danchin N, Popovic B, Puymirat E, Goldstein P, Belle L, Cayla G, et al. five-year outcomes following timely primary percutaneous intervention, late primary percutaneous intervention, or a pharmaco-invasive strategy in st-segment elevation myocardial infarction: the fast-mi programme. Eur Heart J 2020;41:858–66. https://doi.org/10.1093/eurheartj/ehz665.

Batchelor RJ, Dinh D, Brennan A, Wong N, Lefkovits J, Reid C, et al. relation of timing of percutaneous coronary intervention on outcomes in patients with non-st segment elevation myocardial infarction. Am J Cardiol 2020;136:15–23. https://doi.org/10.1016/j.amjcard.2020.09.011.

Iantorno M, Shlofmitz E, Rogers T, Torguson R, Kolm P, Gajanana D, et al. should non-st-elevation myocardial infarction be treated like st-elevation myocardial infarction with shorter door-to-balloon time?. Am J Cardiol 2020;125:165–8. https://doi.org/10.1016/j.amjcard.2019.10.012.

Siddiqi TJ, Usman MS, Khan MS, Sreenivasan J, Kassas I, Riaz H, et al. meta-analysis comparing primary percutaneous coronary intervention versus pharmacoinvasive therapy in transfer patients with st-elevation myocardial infarction. Am J Cardiol 2018;122:542–7. https://doi.org/10.1016/j.amjcard.2018.04.057.

Shoaib A, Kinnaird T, Curzen N, Kontopantelis E, Ludman P, de Belder M, et al. outcomes following percutaneous coronary intervention in non–st-segment–elevation myocardial infarction patients with coronary artery bypass grafts. Circ Cardiovasc Interv 2018;11. https://doi.org/10.1161/CIRCINTERVENTIONS.118.006824.