Incidence of major adverse cardiac and cerebrovascular events following primary percutaneous coronary intervention in central iran

Abbas  Andishmand; Seyedeh Mahdiah  Namayandah; Mehraban  Ziafat

doi:10.18502/cbj.v4i2.17791

Abbas Andishmand Yazd Cardiovascular Research Center, Non- communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Seyedeh Mahdiah Namayandah Yazd Cardiovascular Research Center, Non- communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mehraban Ziafat Yazd Cardiovascular Research Center, Non- communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/cbj.v4i2.17791

Keywords: major adverse cardiac and cerebrovascular events (MACCE), myocardial infarction, primary percutaneous coronary intervention (PPCI), ST-elevation myocardial infarction (STEMI)

Abstract

Objectives: ST-segment elevation myocardial infarction (STEMI) is a critical form of acute coronary syndrome that requires immediate myocardial reperfusion to reduce infarct size and enhance patient outcomes. Despite improvements in the management of STEMI, it continues to be a global contributor to mortality. This study aimed to evaluate the long-term prognosis and outcomes of STEMI patients by investigating the incidence of major adverse cardiac and cerebrovascular events (MACCE).

Methods: This prospective cohort study enrolled 305 patients diagnosed with STEMI between March 2016 and February 2017 in Afshar Hospital, a tertiary cardiac hospital in central Iran. The researchers performed Primary percutaneous coronary intervention (PCI) using drug-eluting stents (DES), and patients received standard medical therapy. Data on major adverse cardiac and cerebrovascular events (MACCE), demographic characteristics, clinical factors, and procedural details were collected through patient interviews, medical records, and the myocardial infarction registry database.

Results: The overall success rate of primary PCI was 92.8%. Hypertension was the most prevalent risk factor for coronary artery disease (41.1%). During the one-year follow-up, the incidence of MACCE was 15.1% (46 patients), with death being the most common occurring in 33 patients (10.8%). Mortality rates were highest within the first six months. The multivariate logistic regression analysis revealed that age (P=0.001) and stent length exceeding 30 mm (P=0.036) were significant predictors of mortality.

Conclusions: This study provides important insights into primary PCI outcomes in STEMI patients in central Iran. The findings indicate a high success rate for PCI and emphasize the necessity for timely and appropriate management. MACCE incidence, especially mortality, highlights the importance of ongoing surveillance and comprehensive follow-up care.