Abstract 13193: Impact of “Off-Peak” Versus “Peak” Hour Coronary Interventions for ST-Elevation Myocardial Infarction on Adverse Outcomes
Background: In addition to patient-dependent factors, whether the time of arrival of the patient to the hospital with ST-elevation myocardial infarction (STEMI) might play a role in subsequent adverse outcomes following primary percutaneous coronary interventions (PCI) is not well studied.
Method: 856 PCI procedures for patients presenting with STEMI from two large hospitals in the health system were analyzed. Peak hours were defined as procedures performed between 7 AM and 7 PM on weekdays. Off-peak hours were defined as procedures performed between 7 PM and 7 PM on weekdays and weekends. Unadjusted and propensity score-adjusted analyses were performed to analyze the following inpatient outcomes: composite of death/MI/stroke, composite of bleeding events, composite of death/MI/stroke/bleeding endpoints, and long-term mortality.
Results: Of 856 PCIs, 407 (47.5%) were performed during the peak hours. In both unadjusted and propensity score-adjusted analyses, no significant differences in adverse outcomes and long-term mortality were observed in patients who had PCIs during off-peak and peak hours (see Table). In addition, a separate analysis performed on patients who underwent primary PCIs between 7 AM-7 PM (“Morning”) versus 7 PM-7 AM (“Evening”) on all days showed no difference in the inpatient adverse outcomes and long-term mortality (Adjusted long term mortality: HR 0.79 (95% CI 0.40-1.56), p=0.49).
Conclusion: Primary PCIs performed on patients presenting with STEMI during off-peak versus peak hours results in similar inpatient adverse outcomes and long-term mortality.
Author Disclosures: J.S. Lee: None. G. Redel-Traub: None. M. Kim: None. P. Meraj: None. C. Brennan: None. V. Vidi: None.
- © 2015 by American Heart Association, Inc.