Solaiman Hossain^1,, Moeen Uddin Ahmed¹, Md. Shahimur Parvez¹, Debasish Debnath¹, Md. Mahidur Rahman¹, Anup Kumar Das¹, Tamal Peter¹

Introduction: Primary percutaneous coronary intervention (PPCI) is the best reperfusion option in ST-segment elevation myocardial infarction (STEMI) when performed timely but PPCI is not universally available. Hence, Pharmacoinvasive (PhI) reperfusion strategy is recommended for STEMI patients. However, there are very few studies in Bangladesh for the comparison of efficacy and outcome of PPCI and PhI Strategy. The aim of this study is to compare the efficacy and outcome of PPCI and PhI strategies in patients of Bangladesh. Methodology and Materials: This was a prospective observational comparative study. A total of 783 acute STEMI patients were included in Enam Medical College Hospital, Savar, Dhaka, Bangladesh during December-2015 to April-2019. Among them, 103 patients underwent Primary PCI and 184 patients underwent PhI strategy. Data were collected prospectively using a standardized case report form. Chai-squared tests were done to compare the ratio of the frequency of the groups and t-tests were done to compare the mean of the groups with 95% CI where p<0.05 considered as significant. Results: Among the studied patients, access site complications in PPCI were hematoma, occlusion and pseudo-aneurysm being observed 03(2.91%), 05(4.85) and (0%), whereas, in PhI strategy were 09(4.89%), 08(4.34%), and 02(1.08%) respectively (P>0.05). In hospital, primary composite cardiovascular outcome of death, reinfarction, stroke and CHF were noted insignificant in both the strategies (p>0.05). On follow-up at 01 month, 06 month and 12 month, the composite cardiovascular outcome of death, reinfarction, stroke and CHF) were 03(3.84%), 04(5.12%), and 05(6.41%), in PPCI and 04(2.81%), 09(6.33%), and 07(4.92%) respectively in PhI strategy (P>0.05). Conclusion: Similar clinical, in hospital, and followed up outcomes were found when comparing the efficacy and safety Primary PCI to PhI Strategy in patients with STEMI who were eligible for reperfusion. So, both Primary PCI and Pharmacoinvasive strategies are safe and effective in management of patients with STEMI.

ST-Segment elevation myocardial infarction, primary percutaneous coronary intervention, pharmacoinvasive strategy