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Percutaneous Coronary Intervention as Clinical Outcome Predictor for in-Hospital Adverse Events in STEMI Patients

Heart Science Journal · Vol. 3 No. 2 (2022) · hlm. 10–17

DOI
10.21776/ub.hsj.2022.003.02.3
ISSN
2721-9984, 2721-9976
Terbit
2022-04-30
Penerbit
Universitas Brawijaya
Bahasa
en

Abstrak

BackgroundÂ: Limited resources and the concurrent COVID19 pandemic hinders the appropriate time to achieve reperfusion in Infarct-related artery (IRA). The number of patients receiving late primary PCI (PPCI) and without revascularization are steadily increase within 2 years into the pandemic. The impact of PCI timing in this setting has not been fully elucidated.ObjectiveÂ: This study was conducted to evaluate the effect of early PPCI vs late PPCI vs non revascularization groups towards in-hospital mortality and complications. This study also aimed to determine whether PPCI is the main predictor for in-hospital adverse events in STEMI patients.MethodÂ: Data of STEMI patients registered in Saiful Anwar General Hospiital ACS registry were collected between 2018-2021 Patients were subdivided into early PPCI if receiving PCI within the recommended time of the 2017 ESC STEMI management guideline, late PPCI if receiving PCI outside the timeframe provided by the guideline, and optimal medical therapy group if not receiving any means of revascularization. Patients undergoing thrombolysis were excluded. Afterwards, the incidence of in-hospital adverse event were calculated as primary endpoints, development of immediate complications during hospitalizations were analyzed as secondary endpoints. Stratification of baseline characteristics and PCI categorizations were performed using multivariate analysis to determine the main predictor of in-hospital mortality between STEMI patients.ResultsÂ:  568 STEMI patients were included in the study with 387 in early PPCI, 107 in late PPCI, and 74 in optimal medical therapy group. Incidence of in-hospital mortality were significantly higher in optimal medical therapy group and lowest in early PPCI group (32.4% and 7.5% respectively, P 0.00). Mortality odds ratio between early PPCI group and optimal medical therapy group were significantly lowest (OR 0.17, 95% CI 0.13 – 0.41). Complications between each treatment groups were significantly different with early PPCI had the lowest incidence of in-hospital complications of cardiogenic shock, cardiac arrest, and VT/VF. Stratification of baseline characteristics and PCI category reveals that timing PPCI is the main predictor for in-hospital adverse events (HR 4.506, 95% CI 2.487-6.662, P 0.00). ConclusionÂ: Percutaneous coronary intervention is the main predictor for the incidence of in hospital mortality and complications in STEMI patients.Keyword: STEMI, PCI, mortality, complications, in-hospital adverse events.

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  • University of Brawijaya
  • RSUD Prof. Dr. Saiful Anwar Malang
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Rekan penulisOrganisasiArtikel bersama
Anna Fuji RahimahUniversity of Brawijaya56
Cholid Tri TjahjonoUniversity of Brawijaya45
Budi SatrijoUniversity of Brawijaya39
Novi KurnianingsihUniversity of Brawijaya38
Sasmojo WiditoUniversity of Brawijaya27
Djanggan SargowoUniversity of Brawijaya24
Yoga WaranugrahaUniversity of Brawijaya14
Wella KarolinaUniversity of Brawijaya14
Valerinna YogibuanaAfiliasi tidak diketahui14
Adhika Prastya WikanandaUniversity of Brawijaya10
Tri AstiawatiUniversity of Brawijaya9
Tria Yudha NugrahaUniversity of Brawijaya8
Putri Annisa KamilaUniversity of Brawijaya8
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya8
Muhammad Rizki FadlanUniversity of Brawijaya7
Danti Utami SetyowatiRSUD Prof. Dr. Saiful Anwar Malang7
Fahmy RusnantaUniversity of Brawijaya7
Seprian WidasmaraUniversity of Brawijaya7
Hayla Iqda MillisaniUniversity of Brawijaya6
Lutfi Hafiz ZunardiUniversity of Brawijaya6
Fandy HazzyUniversity of Brawijaya5
Olivia HandayaniUniversity of Brawijaya5
Oktafin Srywati PamunaUniversity of Brawijaya5
Krishna Ari NugrahaUniversity of Brawijaya5
Anna Fuji RahimahAfiliasi tidak diketahui5
Ratna PancasariUniversity of Brawijaya5
Ayu Asri Devi AdityawatiUniversity of Brawijaya5
Dion SetiawanUniversity of Brawijaya5
Akhmad Isna NurudinullohUniversity of Brawijaya5
Dea Arie KurniawanUniversity of Brawijaya5
Dadang HendrawanUniversity of Brawijaya4
Indra Jabbar AzizUniversity of Brawijaya4
Mokhamad Aswin BaharUniversity of Brawijaya4
Teguh AryanugrahaUniversity of Brawijaya3

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Percutaneous Coronary Intervention as Clinical Outcome Predictor for in-Hospital Adverse Events in STEMI Patients</dc:title>
	<dc:creator xml:lang="en">Santoso, Anita Surya</dc:creator>
	<dc:creator xml:lang="en">Rohman, Mohammad Saifur</dc:creator>
	<dc:creator xml:lang="en">Rizal, Ardian</dc:creator>
	<dc:creator xml:lang="en">Anjarwani, Setyasih</dc:creator>
	<dc:creator xml:lang="en">Martini, Heny</dc:creator>
	<dc:creator xml:lang="en">Prasetya, Indra</dc:creator>
	<dc:subject xml:lang="en">STEMI</dc:subject>
	<dc:subject xml:lang="en">PCI</dc:subject>
	<dc:subject xml:lang="en">mortality</dc:subject>
	<dc:subject xml:lang="en">complications</dc:subject>
	<dc:subject xml:lang="en">in-hospital adverse events.</dc:subject>
	<dc:description xml:lang="en">Background : Limited resources and the concurrent COVID19 pandemic hinders the appropriate time to achieve reperfusion in Infarct-related artery (IRA). The number of patients receiving late primary PCI (PPCI) and without revascularization are steadily increase within 2 years into the pandemic. The impact of PCI timing in this setting has not been fully elucidated.Objective : This study was conducted to evaluate the effect of early PPCI vs late PPCI vs non revascularization groups towards in-hospital mortality and complications. This study also aimed to determine whether PPCI is the main predictor for in-hospital adverse events in STEMI patients.Method : Data of STEMI patients registered in Saiful Anwar General Hospiital ACS registry were collected between 2018-2021 Patients were subdivided into early PPCI if receiving PCI within the recommended time of the 2017 ESC STEMI management guideline, late PPCI if receiving PCI outside the timeframe provided by the guideline, and optimal medical therapy group if not receiving any means of revascularization. Patients undergoing thrombolysis were excluded. Afterwards, the incidence of in-hospital adverse event were calculated as primary endpoints, development of immediate complications during hospitalizations were analyzed as secondary endpoints. Stratification of baseline characteristics and PCI categorizations were performed using multivariate analysis to determine the main predictor of in-hospital mortality between STEMI patients.Results :  568 STEMI patients were included in the study with 387 in early PPCI, 107 in late PPCI, and 74 in optimal medical therapy group. Incidence of in-hospital mortality were significantly higher in optimal medical therapy group and lowest in early PPCI group (32.4% and 7.5% respectively, P 0.00). Mortality odds ratio between early PPCI group and optimal medical therapy group were significantly lowest (OR 0.17, 95% CI 0.13 – 0.41). Complications between each treatment groups were significantly different with early PPCI had the lowest incidence of in-hospital complications of cardiogenic shock, cardiac arrest, and VT/VF. Stratification of baseline characteristics and PCI category reveals that timing PPCI is the main predictor for in-hospital adverse events (HR 4.506, 95% CI 2.487-6.662, P 0.00). Conclusion : Percutaneous coronary intervention is the main predictor for the incidence of in hospital mortality and complications in STEMI patients.Keyword : STEMI, PCI, mortality, complications, in-hospital adverse events.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2022-04-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/1336</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2022.003.02.3</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 3 No. 2 (2022): Improving ST-Elevation Myocardial Infraction Patients Prognosis; 10-17</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2022.003.02</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/1336/257</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2022 Anita Surya Santoso</dc:rights>
</oai_dc:dc>