Cardiovascular outcomes of early versus delayed coronary intervention in low to intermediate-risk patients with STEMI in Thailand: a randomised trial. Issue 2 (12th June 2019)

• Record Type: Journal Article
• Authors: Chotechuang, Yotsawee; Phrommintikul, Arintaya; Kuanprasert, Srun; Muenpa, Roungtiva; Patumanond, Jayanton; Chaichuen, Tuanchai; Sukonthasarn, Apichard
• Is Part Of: Heart Asia. Volume 11:Issue 2(2019)
• Publication Date: 2019-06-12
• Subjects: early coronary intervention -- delayed coronary intervention -- ST-elevation myocardial infarction -- successful streptokinase therapy -- low to intermediate GRACE risk score
• DOI: 10.1136/heartasia-2019-011201
• Languages: English
• ISSNs: 2398-5968

Abstract

Abstract : Background: The benefit of an early coronary intervention after streptokinase (SK) therapy in low to intermediate-risk patients with ST-elevation myocardial infarction (STEMI) still remains uncertain. The current study aimed to evaluate the cardiovascular outcomes of early versus delayed coronary intervention in low to intermediate-risk patients with STEMI after successful therapy with SK. Methods: We randomly assigned low to intermediate Global Registry of Acute Coronary Events risk score to patients with STEMI who had successful treatment with full-dose SK at Lampang Hospital and Maharaj Nakorn Chiang Mai Hospital into early and delayed coronary intervention groups. The primary endpoints were 30-day and 6-month composite cardiovascular outcomes (death, rehospitalised with acute coronary syndrome, rehospitalised with heart failure and stroke). Results: One hundred and sixty-two patients were included in our study. At the 30 days, composite cardiovascular outcomes were 4.9% in the early coronary intervention group and 2.5% in the delayed group (p=0.682). At the 6 months, the composite cardiovascular outcomes were 16.1% in the early group and 6.2% in the delayed group (p=0.054). Conclusions: The delayed coronary intervention (>24 hours) in low to intermediate STEMI after successful therapy with SK did not increase in short and long-term cardiovascular events compared with an early coronary intervention. Trial registration number: NCT02131103 .