Comparative outcomes of primary percutaneous coronary intervention and pharmacoinvasive strategies in patients with ST-elevation myocardial infarction in palestine: a multicenter retrospective cohort study

Abstract Background ST-elevation myocardial infarction (STEMI) requires prompt reperfusion. This study compared short-term outcomes of primary PCI and pharmacoinvasive reperfusion at two tertiary centers in the West Bank, Palestine. Methods This multicenter retrospective cohort included 160 adults aged 30–75 years: 82 treated with primary PCI at An-Najah National University Hospital and 78 managed with a pharmacoinvasive strategy at Palestine Medical Complex. Data were abstracted from medical records using a structured form and analyzed with SPSS. Results A total of 160 patients with STEMI were included, of whom 82 (51.2%) underwent primary PCI and 78 (48.8%) were managed using a pharmacoinvasive strategy. The groups differed in several baseline characteristics, including age, dyslipidemia, obesity, echocardiographic findings, and baseline ejection fraction. At least one postoperative complication occurred in 17/82 (20.7%) patients in the primary-PCI group compared with 52/78 (66.7%) patients in the pharmacoinvasive group. After adjustment for age, dyslipidemia, obesity, valve regurgitation, cardiac hypokinesia, and baseline ejection fraction, the pharmacoinvasive strategy remained associated with higher odds of experiencing at least one postoperative complication (adjusted OR = 6.96, 95% CI 2.78–17.45, p < 0.001). Thirty-day survival was 98.8% (81/82) in the primary-PCI group and 87.2% (68/78) in the pharmacoinvasive group. Conclusion Primary PCI was associated with more favorable observed short-term outcomes than the pharmacoinvasive pathway. However, residual confounding, particularly by hospital site, cannot be excluded; therefore, these findings should be interpreted as observational associations rather than causal treatment effects.