Comparison of the 3-Month Outcome Between Primary PCI and Thrombolytic Therapy Concerning the Left Ventricular Ejection Fraction of STEMI Patients at 90-Minute Intervals

Standard treatment in patients with ST‐elevation myocardial infarction (STEMI) is the reperfusion therapy of coronary arteries with the most appropriate therapeutic method. The purpose of the present study was to compare the 3-month outcome between primary percutaneous coronary intervention (P-PCI) and thrombolytic therapy regarding the ejection fraction (EF) of patients with STEMI who were referred to 2 hospitals in Tehran with the same door-to-balloon and door-to-needle times (≈90 min).

This cohort study enrolled 43 patients referred to Taleghani Hospital and Labbafinejad Hospital, affiliated with Shahid Beheshti University of Medical Sciences, in Tehran, Iran. Based on a researcher-made questionnaire, the initial and the 3-month EFs in the P-PCI group (n=19) and the thrombolytic therapy group (n=24) were determined and compared.

No significant differences were found in demographic variables between the 2 therapeutic methods. Most participants were aged 60 years or older and male. The outcome of P-PCI and thrombolytic therapy in terms of the EF showed no significant differences at baseline (41% vs 42.6%) and 3 months’ follow-up (50.2% vs 50.3%) (P>0.05). Additionally, the mortality and rehospitalization rates were the same in both groups (P>0.05).

No significant differences were observed in the 3-month outcome between P-PCI and thrombolytic therapy at 90-minute treatment intervals concerning the EF of patients with STEMI. Thus, either one may be used based on access to the Cath Lab and the patient’s situation. (Iranian Heart Journal 2021; 22(4): 45-53)