Impact of time delay on short term outcomes of primary percutaneous coronary intervention (PCI) in Pakistani population

Abstract Objective: To evaluate the impact of time delay on short-term outcomes of primary percutaneous coronary intervention in the Pakistani population, focusing on patients treated at Hayatabad Medical Complex, Peshawar. Methodology: A retrospective analysis was conducted on 322 STEMI patients treated between January and December 2023. Patients were divided into "On-Time PCI" (<90 minutes, n=161) and "Delayed PCI" (>90 minutes, n=161) groups. Data on LV function, MACE, mortality, and total ischemic time were collected and analyzed using t-tests, chi-square tests, and multivariate regression. Results: The "On-Time PCI" group had a considerably higher mean LV function (55.1 ± 4.8%) than the "Delayed PCI" group (44.8 ± 6.3%, p < 0.001). The "On-Time PCI" group had a lower MACE incidence (6.8%) than the "Delayed PCI" group (27.3%, p < 0.001). Mortality rates were 2.5% in the "On-Time PCI" group and 9.3% in the "Delayed PCI" group (p = 0.004). Multivariate regression identified delayed PCI as a predictor of lower LV function (coefficient = -9.8, p < 0.001), higher MACE (odds ratio = 4.5, p < 0.001), and increased mortality (odds ratio = 3.2, p = 0.02). Conclusion: Delayed PCI timing significantly worsens outcomes in STEMI patients, emphasizing the need for timely intervention. Strategies to reduce delays are critical for improving myocardial recovery and survival.