Clinical Outcome Study between Primary Percutaneous Coronary Intervention and Pharmacoinvasive Strategy in ST Segment Elevation Myocardial Infarction Patients

Abstract

Background: Rapid coronary artery opening is key to the treatment of patients with ST segment Elevation Myocardial Infarction (STEMI) with Primary PCI as the standard method. However, thrombolytic drugs are administered. Tenecteplase (TNK) combined with PCI (Pharmacoinvasive strategy) is an important option in hospitals that are unable to perform PCI in time. This study aimed to compare clinical outcomes between Primary PCI and Pharmacoinvasive strategies in STEMI patients.

Objectives: To evaluate and compare the clinical outcomes of STEMI patients treated with primary PCI versus a pharmacoinvasive strategy.

Methods: This is a retrospective study in patients. STEMI treated with primary PCI or pharmacoinvasive strategy using TNK followed by coronary artery injections and PCI during the period from January 1, 2024 to August 31, 2025. Clinical outcomes: Assess major adverse cardiovascular event (MACE) including death. Recurrent myocardial infarction Stroke and cardiac shock, and complications from abnormal bleeding, as well as following up with patients. 30 days to assess MACE

Results: Patients in the pharmacoinvasive strategy group compared with  the primary PCI group found that there was no significant difference in MACE incidence and mortality and no bleeding disorders were observed in either group. After 30 days of follow-up in both groups of patients, it was found that the incidence rate of MACE does not differ significantly.

Conclusions: The Study was limited by a smaller sample size than initially calculated. Nevertheless, the findings suggested that the pharmacoinvasive strategy tended to yield outcomes comparable to primary PCI in terms of mortality, MACE and major bleeding.