Short-Term Clinical Outcomes of Percutaneous Coronary Intervention in Late-Presenting STEMI Patients Without Prior Thrombolysis

Abstract

Objectives: To evaluate the short-term clinical outcomes of Percutaneous Coronary Intervention (PCI) in late-presenting ST-Elevation Myocardial Infarction (STEMI) patients who have not received prior thrombolysis, focusing on mortality, major adverse cardiac events (MACE), and in-hospital complications.

Methodology: This prospective observational study was conducted at Hayatabad Medical Complex, Peshawar, Pakistan, from September 2023 to August 2024. A total of 250 late-presenting STEMI patients (with symptom onset between 12 and 48 hours) who had not received thrombolytic therapy underwent PCI. Demographic data, procedural success, and in-hospital outcomes were recorded and analyzed. Statistical analysis was performed using SPSS version 25, with statistical significance set at p < 0.05.

Results: The mean age of participants was 61.2 ± 7.4 years, with 80% of the cohort being male. The mean total ischemic time was 18.5 ± 3.2 hours. PCI was successfully performed in 92% of patients. In-hospital mortality occurred in 6% of patients, while 12% experienced MACE. Additional complications included heart failure (7.2%) and arrhythmias (4.8%). Multivariate analysis identified advanced age and heart failure as significant predictors of in-hospital mortality (p < 0.05).

Conclusion: PCI in late-presenting STEMI patients without prior thrombolysis yields favorable short-term outcomes, characterized by a high procedural success rate and manageable complication rates. These findings reinforce the value of PCI as an effective intervention, even in delayed presentations, contributing to improved patient outcomes in resource-limited settings.