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Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-008

Characteristics, Temporal Trends, and Impact of Revascularization in Latecomer ST-Elevation Myocardial Infarction Patients

By Walid Jomaa, Nesrine Amdouni, Ikram Chamtouri, Khaldoun Ben Hamda, Faouzi Maatouk

Presenter

Walid Jomaa

Authors

Walid Jomaa1, Nesrine Amdouni1, Ikram Chamtouri1, Khaldoun Ben Hamda1, Faouzi Maatouk1

Affiliation

Fattouma Bourguiba University Hospital, Tunisia1
View Study Report
TCTAP A-008
Acute Coronary Syndromes (STEMI, NSTE-ACS)

Characteristics, Temporal Trends, and Impact of Revascularization in Latecomer ST-Elevation Myocardial Infarction Patients

Walid Jomaa1, Nesrine Amdouni1, Ikram Chamtouri1, Khaldoun Ben Hamda1, Faouzi Maatouk1

Fattouma Bourguiba University Hospital, Tunisia1

Background

Although the rate of latecomer among patients with ST-segment elevation myocardial infarction (STEMI) appears to have decreased over the last years, the optimal management of these patients is still debated. The aim of this study was to describe characteristics, temporal trends and impact of revascularization on in-hospital mortality of patients with STEMI presenting later than 12 hours after symptom onset.

Methods

All STEMI patients admittedto Cardiology B department of FattoumaBourguiba University Hospital (Monastir, Tunisia) between January 1998 and December 2017 were retrospectively enrolled in a registry. Studypopulation was divided into patients presenting later than 12 hoursafter symptom onset (latecomer) and patients presenting within 12 hours(early-comer).

Results

Out of 1734 patients, 224 (12.9 %) were latecomers. Prevalence of late presentation decreased from 17.6 % to 8.3 % (p < 0.001) throughout the study period. Compared to early-comers, latecomers tended to be older (63.9 ± 12 vs 59.2 ± 12 years, p < 0.001) and were more commonly male (p < 0.001). Diabetes, hypertension and chronic kidney disease were more prevalent in latecomers. Latecomer STEMI patients were more likely to present with cardiogenic shock (23.2 % vs 12.7 %, p = 0.001) compared with early comers. In the latecomer group, there was a marked increase in the use of percutaneous coronary intervention (PCI) over time from 7 % to 46.9 %(p < 0.001).  All cause in-hospital mortality in latecomers was reduced from 23.2 % to 10.9 % (p < 0.001). In multivariate analysis, primary PCI had an independent protective effect onin-hospital mortality in latecomer STEMI patients (OR = 0.65; 95 % CI, 0.50 - 0.84,p = 0.001).

Conclusion

According to the present study, there was a progressive decrease in latecomers prevalence in STEMI patients along with a reduction in in-hospital mortality rate. This reduction was concomitant with an increase in primary PCI implementation in this setting.

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