Evidence map›Paper›PMID 39877021›Full record

ArticleFrontiers in cardiovascular medicine2024

Optimal timing of pharmacoinvasive strategy and its impact on clinical and economic outcomes in patients with ST-elevation myocardial infarction: a real-world perspective.

Andrea Dias Stephanus, Alice Pacheco Santos, Ana Carolina Machado Rodrigues da Cunha, Ana Carolina Augusto Rocha, Amanda de Amorim Meireles, Mariana Guimarães Souza de Oliveira, Pietra Arissa Coelho Matsunaga, Alexandre Anderson de Sousa Munhoz Soares, Ana Claudia Cavalcante Nogueira, Adriana de J B de Almeida Guimarães and 3 more

Abstract read
In one paragraph

Article in Frontiers in cardiovascular medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Andrea Dias StephanusLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Alice Pacheco SantosLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Ana Carolina Machado Rodrigues da CunhaLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Ana Carolina Augusto RochaLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Amanda de Amorim MeirelesLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Mariana Guimarães Souza de OliveiraLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Pietra Arissa Coelho MatsunagaLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.
Alexandre Anderson de Sousa Munhoz SoaresAramari Apo Institute, Brasília, Brazil.
Ana Claudia Cavalcante NogueiraAramari Apo Institute, Brasília, Brazil.
Adriana de J B de Almeida GuimarãesEscola Superior de Ciências da Saúde (ESCS), Brasília, Brazil.
Gustavo de Almeida AleximSecretaria de Estado de Saúde do Distrito Federal (SES-DF), Brasília, Brazil.
Alessandra M Campos-StafficoDepartment of Pharmacy Sciences | School of Pharmacy and Health Professions, Creighton University, Omaha, NE, United States.
Luiz Sergio Fernandes de CarvalhoLaboratory of Data for Quality of Care and Outcomes Research (LaDa:QCOR), Catholic University of Brasilia, Brasília, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The pharmacoinvasive (PhI) strategy is the standard-of-care for ST-elevation myocardial infarction (STEMI) patients when primary percutaneous coronary intervention (pPCI) is unfeasible. Optimal timing for post-fibrinolytic PCI (lysis-PCI) remains elusive. Therefore, this study aimed to assess the clinical and economic impacts of early vs. delayed lysis-PCI in patients with STEMI. Methods: This retrospective cohort study included 1,043 STEMI patients classified by lysis-PCI timing. The primary outcome was in-hospital major adverse cardiovascular events (4p-MACE), with secondary outcomes such as 3p-MACE, in-hospital mortality, and costs. Multivariable logistic regression models were used to assess the association between lysis-PCI timing and outcomes. Cost analyses were conducted from the perspective of Brazilian public healthcare system, with values converted to international dollars (Int$) for broader applicability. Results: Every 4-h delay in lysis-PCI was associated with a 44% reduction in in-hospital mortality [OR = 0.560 (95% CI: 0.381-0.775); Conclusion: Delaying lysis-PCI was found to be associated with reduced in-hospital cardiovascular adverse events and lower costs, particularly among older adults. Further research should develop evidence-based lysis-PCI protocols that optimize both clinical outcomes and cost-effectiveness.

Indexed as

fibrinolysispercutaneous coronary interventionpharmacoinvasive strategyreperfusion strategyST-segment elevation myocardial infarction

Identifiers

PMID39877021
PMCPMC11772263

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.