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dc.contributor.authorBatchelor, R.J.
dc.contributor.authorDinh, D.
dc.contributor.authorBrennan, A.
dc.contributor.authorWong, N.
dc.contributor.authorLefkovits, J.
dc.contributor.authorReid, Christopher
dc.contributor.authorDuffy, S.J.
dc.contributor.authorChan, W.
dc.contributor.authorCox, N.
dc.contributor.authorLiew, D.
dc.contributor.authorStub, D.
dc.date.accessioned2023-11-14T07:07:14Z
dc.date.available2023-11-14T07:07:14Z
dc.date.issued2020
dc.identifier.citationBatchelor, R.J. and Dinh, D. and Brennan, A. and Wong, N. and Lefkovits, J. and Reid, C. and Duffy, S.J. et al. 2020. Relation of Timing of Percutaneous Coronary Intervention on Outcomes in Patients With Non-ST Segment Elevation Myocardial Infarction. American Journal of Cardiology. 136: pp. 15-23.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/93758
dc.identifier.doi10.1016/j.amjcard.2020.09.011
dc.description.abstract

International guidelines suggest revascularization within 24 hours in non-ST segment elevation myocardial infarction (NSTEMI). Within a large population cohort study, we aimed to explore clinical practice regarding timing targets for percutaneous coronary intervention (PCI) in NSTEMI. The Victorian Cardiac Outcomes Registry was established in 2013 as a state-wide clinical quality registry, pooling data from public and private PCI capable centers. Data were collected on 11,852 PCIs performed for NSTEMI from 2014 to 2018. Patients were divided into 3 groups by time of symptom onset to PCI (<24 hours; 24 to 72 hours; >72 hours). We performed multivariable logistic regression analysis conditional on several baseline covariates in investigating the impact of timing of PCI in NSTEMI on clinical outcomes. Patients who underwent PCI within 24 hours represented 18.4% (n = 2,178); 24 to 72 hours 45.8% (n = 5,434); >72 hours 35.8% (n = 4,240). Patients waiting longer for PCI were older (62.6 ± 12.2 vs 64.8 ± 12.6 vs 67.0 ± 12.7, p <0.001), more likely to be female (23.1% vs 24.2% vs 26.4%, p = 0.007), and have diabetes (18.6% vs 21.1% vs 27.1%, p <0.001). Multivariate logistic regression found that as compared with PCI <24 hours, PCI 24 to 72 hours and PCI >72 hours of symptom onset were associated with a decreased risk of 30-day mortality (odds ratio 0.55; 95% confidence interval 0.35 to 0.86, p = 0.008 and odds ratio 0.64; 95% confidence interval 0.35 to 1.01, p = 0.053, respectively). There was no significant difference in 30-day mortality between groups following exclusion of patients presenting with cardiogenic shock or out of hospital cardiac arrest requiring intubation. In conclusion, many registry patients undergo PCI outside the 24-hour window following NSTEMI. This delay is at odds with current guideline recommendations but does not appear to be associated with an increased mortality risk.

dc.languageEnglish
dc.publisherEXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/1111170
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/1136372
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectCardiac & Cardiovascular Systems
dc.subjectCardiovascular System & Cardiology
dc.subjectDELAYED INVASIVE INTERVENTION
dc.subjectIMMEDIATE
dc.subjectANGIOPLASTY
dc.subjectSTRATEGY
dc.subjectTRIALS
dc.subjectAged
dc.subjectCohort Studies
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNon-ST Elevated Myocardial Infarction
dc.subjectPercutaneous Coronary Intervention
dc.subjectTime Factors
dc.subjectTime-to-Treatment
dc.subjectTreatment Outcome
dc.subjectVCOR Investigators
dc.subjectHumans
dc.subjectTreatment Outcome
dc.subjectCohort Studies
dc.subjectTime Factors
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectTime-to-Treatment
dc.subjectPercutaneous Coronary Intervention
dc.subjectNon-ST Elevated Myocardial Infarction
dc.titleRelation of Timing of Percutaneous Coronary Intervention on Outcomes in Patients With Non-ST Segment Elevation Myocardial Infarction
dc.typeJournal Article
dcterms.source.volume136
dcterms.source.startPage15
dcterms.source.endPage23
dcterms.source.issn0002-9149
dcterms.source.titleAmerican Journal of Cardiology
dc.date.updated2023-11-14T07:07:13Z
curtin.departmentCurtin School of Population Health
curtin.accessStatusFulltext not available
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidReid, Christopher [0000-0001-9173-3944]
dcterms.source.eissn1879-1913
curtin.repositoryagreementV3


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