Clinical characteristics and outcomes of Australian and Indian ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI)

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
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Abstract

Introduction

The incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries.

Materials and methods

We compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017–31st Dec 2019).

Results

A total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p < 0.001), were significantly younger (mean age 56.0 vs 63.2 years; p < 0.001), more likely male (84 % vs 80 %; p = 0.046) and diabetic (48 % vs 18 %); p < 0.001). Radial access (50 % vs 88 %; p < 0.001) and TIMI III flow post PCI was also significantly lower (85 % vs 96 %; p < 0.001) with median door-to-balloon time significantly shorter in the Indian cohort (20mins vs 43mins; p < 0.001); however, median symptom to balloon time was significantly longer (245mins vs 160mins; p < 0.001). No significant differences in 30-day mortality (4.0 % vs 2.8 % Australian; p = 0.209) or 1-year mortality (6.5 % vs 4.3 %; p = 0.120) were observed.

Conclusion

Significant differences in demographics and presentation characteristics exist between Indian and Australian STEMI patients treated with pPCI. Indian patients had significantly longer pre-hospital delays and lower achievement of TIMI III flow post PCI, yet shorter in-hospital time to treatment.

澳大利亚和印度 ST 段抬高型心肌梗死 (STEMI) 患者接受初级经皮冠状动脉介入治疗 (PCI) 的临床特征和预后。
导言:据报道,与发达国家相比,印度人群的 STEMI 发病率和随后的死亡率更高。然而,在发达国家和发展中国家之间直接比较当代初级经皮冠状动脉介入治疗(pPCI)治疗策略和 STEMI 患者临床结果的数据非常有限:我们比较了印度和澳大利亚两个三级转诊中心在 3 年内(2017 年 1 月 1 日至 2019 年 12 月 31 日)分别采用经皮冠状动脉介入治疗的 STEMI 患者的人口统计学特征、手术特征、再灌注时间和死亡率:共纳入1293例STEMI患者(896例印度患者与397例澳大利亚患者)。平均而言,印度患者的中位体重指数(BMI)低于澳大利亚患者(BMI 25.4 vs 27.8;P 结论:印度和澳大利亚患者的人口统计学和发病率存在显著差异:接受 pPCI 治疗的印度和澳大利亚 STEMI 患者在人口统计学和发病特征方面存在显著差异。印度患者的院前延迟时间明显较长,PCI 术后 TIMI III 血流的达标率较低,但院内治疗时间较短。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Indian heart journal
Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
6.70%
发文量
82
审稿时长
52 days
期刊介绍: Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.
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