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

Background: Achieving timely reperfusion for patients with ST segment Elevation Myocardial Infarction (STEMI) remains a challenging problem in developing countries. This study aimed to determine whether late PPCI is the main predictor for in-hospital adverse events in STEMI patients. Method: This study will emphasize the incident of in-hospital adverse events and complications between early PPCI vs late PPCI vs non revascularization groups. A total of 568 STEMI patients were consecutively enrolled from Saiful Anwar General Hospital in between 2018-2021. Patients were subdivided to the timeframe provided by the 2017 ESC STEMI management guideline. The incidence of in-hospital adverse event were calculated as primary endpoints, development of immediate complications during hospitalizations were analyzed as secondary endpoints. Results: Incidence of in-hospital mortality were significantly higher for patients treated without revascularization and lowest in early PPCI group (32.4% and 7.5% respectively, P 0.00). The odds ratio for mortality between early PPCI group and non-revascularization groups 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.