Two-year mortality of primary angioplasty for acute myocardial infarction during regular working hours versus off-hours.


Journal Article

BACKGROUND: Studies with short-term follow-up found higher mortality in patients with STEMI who underwent primary PCI during off-hours as compared to regular working hours. We analyzed the interaction between one and two-year survival of patients with STEMI who underwent primary PCI during regular working hours and off-hours in a tertiary care academic teaching hospital. METHODS: A total of 1126 STEMI patients treated with primary PCI between 2008 and 2013 were analyzed. Two-years follow-up were available in 941 (83%) patients. Multivariable survival analysis was used to estimate the relationship between treatment during off-hours versus regular hours and the incidence of all-cause mortality at 2-years follow-up. Logistic regression was used to calculate interaction p-values between time of admission and time (between ≤1 year and ≤2 year). RESULTS: At 2-years, the mortality rate of patients admitted during off-hours and regular hours was similar (15% vs. 19%; adjusted hazard ratio 0.77; 95% confidence interval 0.52-1.16). Of the 941 patients, those who admitted during off-hours (N = 717) had similar median door-to-device time (94 min vs. 91 min), final Thrombolysis In Myocardial Infarction 3 flow grade (93% vs. 91%) and use of dual antiplatelet within 24 h (96% vs. 98% respectively) as compared with regular hours admission (N = 224). There were no mortality difference observed between one year and two years (p interaction >0.05). CONCLUSION: In this analysis, the similar mortality observed at one year between patients with STEMI treated by primary PCI during off-hour and regular hour were maintained at two years.

Full Text

Duke Authors

Cited Authors

  • Dharma, S; Dakota, I; Sukmawan, R; Andriantoro, H; Siswanto, BB; Rao, SV

Published Date

  • October 2018

Published In

Volume / Issue

  • 19 / 7 Pt B

Start / End Page

  • 826 - 830

PubMed ID

  • 29730236

Pubmed Central ID

  • 29730236

Electronic International Standard Serial Number (EISSN)

  • 1878-0938

Digital Object Identifier (DOI)

  • 10.1016/j.carrev.2018.03.011


  • eng

Conference Location

  • United States