3layout original Article dr Anita suryo
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ehx393 ESC 2017 Ibanez
| 2. Materials and Method
2.1 Study Design This study is using retrospective cohort design in order to evaluate the difference of in hospital clinical outcome, complications, length of stay, and treatment cost between STEMI patients treated with early PPCI, late PPCI, and optimal medical therapy. The research protocol was approved by the Health Research Ethics Commission Saiful Anwar General Hospital. 2.2 Subjects Subjects were STEMI patients pooled using Saiful Anwar General Hospital ACS Registry within duration of 4 years (2018-2021). Consecutive sampling is used as sampling method. The inclusion criteria were as follows: (1) age >18 years old; (2) willing to partici- pate in the study; (3) all STEMI patients undergoing PPCI. Subjects were excluded if they fall into one or more of the following criteria: (1) incomplete data sets; (2) unstable angina pectoris and/or NSTEMI patients; (3) STEMI patients undergoing fibrinolytic without subsequent PPCI; (4) patients with underlying structural heart disease and/or accompanied with/without other underlying metabolic disorder. 2.3 Intervention category Selected subjects were divided into three categories: (1) Patients receiving early PPCI defined as PCI performed within 12 hours onset of symptoms, PCI performed <90 minutes after failed fibrinolyt- ic, and PCI performed >12 hours after onset of symptoms with unstable hemodynamic; (2) Patients receiving late PPCI defined as PCI performed >12 hours after onset of symptoms with stable hemodynam- ic, PCI performed >90 minutes after failed fibrinolytic, and PCI performed >48h after onset of symtoms; (3) Patients receiving optimal medical therapy defined as STEMI patients which did not undergo reperfusion treatment, e.g. PPCI and/or fibrinolytic. The grouping criteria was divided based on timeframe according to 2017 ESC Guide- line for the management of acute myocardial infarction in patients presenting with ST-segment elevation. 2.4 Clinical Outcomes The primary outcome was in hospital adverse events defined as all-cause mortality during hospitalization; the secondary outcomes were cardiovascular (CV) complications consisted of: (1) cardiogenic shock; (2) acute heart failure; (3) pneumonia; (4) stroke; (5) acute renal failure; (6) cardiac arrest; (7) arrhythmia defined as VT/VF, AF/SVT, TAVB/Junctional/Third degree AV Block. We also provide analysis regarding length of stay and treatment cost during hospitaliza- tion in each group. 2.5 Data Analysis Baseline characteristics were analyzed using univariate analysis and the data were presented as mean ± standard deviation (SD). Independent t-test was performed to differentiate mean between 11 intervention group. Normality test using Kolmogorov-Smirnov test was conducted to determine the normality and homogeneity of the data. Finally we performed multivariate logistic regression test to establish the relationship of PPCI as a predictor for in hospital adverse events in STEMI patients. Stratification and multivariate analysis was done to identify potential confounding factors and evaluate the strength between variables. All data were statistically analyzed using SPSS 22.0. P<0.05 was considered significant. tải về 251.28 Kb. Chia sẻ với bạn bè của bạn:
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