Coronary disease & ACSCohort study
Five-year outcomes following timely primary percutaneous intervention, late primary percutaneous intervention, or a pharmaco-invasive strategy in ST-segment elevation myocardial infarction: the FAST-MI programme
- Prospective cohort study (nationwide observational registry surveys)
- multicentre
- propensity-score matched
- Cox multivariable analysis
Authors' conclusion
A substantial proportion of patients have pPCI beyond recommended timelines. As foreseen by the guidelines, these patients have poorer 5-year outcomes, compared with a pharmaco-invasive strategy.
Study context
- Population
- STEMI patients with reperfusion therapy and onset-to-first call <12 h, FAST-MI 2005 and 2010 cohorts (France)of 4250 STEMI patients
- Participants
- 2,942 patients
- Exposure
- Timely primary percutaneous coronary intervention (pPCI) vs late pPCI vs pharmaco-invasive strategy
- Timely pPCIn = 1,288
- Late pPCIn = 830
- Pharmaco-invasiven = 824reference
- Outcome
- Survival
- Follow-up
- 5 years
Main finding
As reported in the abstract
Five-year survival
Each group vs pharmaco-invasiveAdjusted hazard ratio (CI)
Late pPCI
1.51(1.13–2.02)
Timely pPCI
1.02(0.75–1.38)
Observational data: associations, not effects.
Further findings
Propensity score-matched cohorts and event-free survival
- Concordant results
- propensity score-matched cohorts
Original publication
Five-year outcomes following timely primary percutaneous intervention, late primary percutaneous intervention, or a pharmaco-invasive strategy in ST-segment elevation myocardial infarction: the FAST-MI programme. Eur Heart J. Published 20 September 2019. doi:10.1093/eurheartj/ehz665
Summarised from the published abstract; every number is checked against it