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Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Mar 20, 2024; 14(1): 88541
Published online Mar 20, 2024. doi: 10.5493/wjem.v14.i1.88541
Impact of primary percutaneous coronary intervention on ST-segment elevation myocardial infarction patients: A comprehensive analysis
Eza Nawzad Saeed, Abdulsatar Kamil Faeq
Eza Nawzad Saeed, Abdulsatar Kamil Faeq, Department of Medicine, Hawler Medical University, Erbil 44001, Kurdistan, Iraq
Author contributions: Faeq AK provided supervision for the project; Saeed EN was responsible for data collection and curation, reviewing and draft preparation.
Institutional review board statement: The study protocol received approval from the Institutional Review Board (IRB) at Hawler Medical University. All research procedures and data collection methodologies were conducted according to the principles of the Declaration of Helsinki and other relevant national and institutional ethical guidelines.
Clinical trial registration statement: This study is registered at college of medicine -Hawler medical university. The registration is required for complete M.Sc.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper. All authors have contributed significantly to the research and preparation of the manuscript and have approved the final version for submission. No external funding was received for this research.
Data sharing statement: Original contributions reflected in this work can be obtained from the article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eza Nawzad Saeed, MBChB, Researcher, Department of Medicine, Hawler Medical University, Erbil - IRAQ 44001, Erbil 44001, Kurdistan, Iraq. demolali542@gmail.com
Received: September 27, 2023
Peer-review started: September 27, 2023
First decision: January 2, 2024
Revised: January 8, 2024
Accepted: February 2, 2024
Article in press: February 2, 2024
Published online: March 20, 2024
Processing time: 173 Days and 22.3 Hours
Abstract
BACKGROUND

Myocardial infarction, particularly ST-segment elevation myocardial infarction (STEMI), is a key global mortality cause. Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center. Multiple factors were identified influencing in-hospital mortality. Significantly, time from symptom onset to hospital arrival emerged as a decisive factor. Consequently, our study hypothesis is: "Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."

AIM

To determine the key factors influencing mortality rates in STEMI patients.

METHODS

We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention (PPCI) at the Erbil Cardiac Center. Their clinical histories were compiled, and coronary evaluations were performed via angiography on admission. Data included comorbid conditions, onset of cardiogenic shock, complications during PPCI, and more. Post-discharge, one-month follow-up assessments were completed. Statistical significance was set at P < 0.05.

RESULTS

Our results unearthed several significant findings. The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2% and 2.3% respectively. On the investigation of independent predictors of in-hospital mortality, we identified atypical presentation, onset of cardiogenic shock, presence of chronic kidney disease, Thrombolysis In Myocardial Infarction grades 0/1/2, triple vessel disease, ventricular tachycardia/ventricular fibrillation, coronary dissection, and the no-reflow phenomenon. Specifically, the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer (6.92 ± 3.86 h) compared to those who survived (3.61 ± 1.67 h), P < 0.001. These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.

CONCLUSION

Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients, highlighting the critical need for prompt intervention.

Keywords: Percutaneous coronary intervention; Impact analysis, Segment elevation; Erbil

Core Tip: Myocardial infarction, particularly the ST-segment elevation myocardial infarction (STEMI) subtype, is a leading global cause of mortality. Primary percutaneous coronary intervention is the preferred treatment, but its success depends on various factors. In a study of 96 consecutive STEMI patients at Erbil Cardiac Center, factors predicting in-hospital mortality included atypical presentation, cardiogenic shock, chronic kidney disease, TIMI grades 0/1/2, triple vessel disease, ventricular tachycardia/ventricular fibrillation, coronary dissection, and no-reflow phenomenon. Significantly, the time from symptom onset to hospital arrival emerged as a critical determinant in improving STEMI prognosis.