Comparative Study between Outcome of PCI in Patients with Reinfarction after PCI Versus Patients with Myocardial Infarction for First Time

Abstract

Background: Primary percutaneous coronary intervention (pPCI) with routine stenting of the culprit lesion has greatly improved the short-term and immediate outcomes of ST-elevation myocardial infarction (STEMI).Objective: This study evaluated the clinical history, in-hospital prognosis, and in-hospital outcome predictors of reinfarction after PCI patients to those of first acute myocardial infarction (AMI) patients, as well as the influence of initial PCI. Patients and Methods: This prospective comparative research involved 60 STEMI patients and managed with invasive strategy to compare between outcomes of PCI in patients who suffered from reinfarction after PCI versus outcomes of PCI in STEMI patients for the first time. Cases were classified into two equal groups: Group I included patients presented with first time STEMI and managed with primary PCI. Groups II included patients managed with PCI after presentation with reinfarction after primary PCI. All patients underwent complete medical history, clinical examination, electrocardiography, laboratory investigations, echocardiography, coronary angiography and primary PCI and inhospital course. Results: There was a statistically significant variation between both studied groups regarding smoking and the adverse outcome. Survived and died were significantly different among group I regarding age, ejection fraction, number of vessels, post TIMI flow, HF, arrythmia, cardiac arrest and mechanical complications. Survived and died were significantly different among group II regarding troponin, ejection fraction, post TIMI flow, HF, arrythmia, cardiac arrest and mechanical complications Conclusions: The outcome of PCI after reinfarction had poor outcome in comparison with PCI in patients with STEMI for the first time.