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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 3, May/June 2019
166
AFRICA
We failed to find significant differences in terms of in-hospital
mortality rate and MACE between the two groups in this study.
Two reasons may explain this. First, all of the enrolled patients
were haemodynamically and electrically stable and had patent
IRAs, which means they had a relatively low risk for mortality
and adverse events, according to the GRACE scoring system.
33
Second, only 159 patients were enrolled in the study, and the
small sample may have reduced the power to draw a significant
conclusion regarding mortality rate.
There were several potential limitations of this study. First,
it is a single-centre, retrospective study with a small sample size.
Second, most recent chest pain within 12 hours before admission
was more likely in the emergency PCI group compared with
the delayed PCI group (Table 2), which may have led to a bias
towards an emergency decision by the operator. Third, we did
not assess the TIMI thrombus grade of the IRA during the initial
angiography since TIMI thrombus grade may have contributed
to different angiography results. Finally, the blush grade was
not evaluated as a more valuable indicator for normalised
microvascular flow since this study was designed retrospectively.
Conclusion
In STEMI patients who presented late (12–72 hours) after
symptom onset and with an IRA TIMI flow of grade 2 to 3,
delayed PCI showed a higher rate of procedural success due to
a lower rate of slow flow or no re-flow, without an increase in
hospital or long-term MACE or mortality rates.
We thank Dr Qian-jin Feng for editing and revision of the manuscript. This
study was supported by the Zhongshan Major Science and Technology
Development Project (Zhong Ke Fa No. 2016B1002).
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