Results
The study identified 45,539 discharges with a principal admission
diagnosis of AMI (38.7% ST elevation and 61.3% non-ST elevation) who
had either PR or SR as a principal procedure (79.1% PR versus 20.9%
SR). Single vessel revascularization was performed in 67.8% (93.1% had
PR versus 6.9% had SR, p<0.01). Multivessel revascularization
was performed in 32.2% (64.8% had PR versus 35.2% had SR,
p<0.01). 83% of SR was in the setting of non-ST elevation AMI
(NSTEMI). In comparison to SR, PR was associated with higher in-hospital
all-cause mortality (3.7% versus 2.2%, P<0.01), shorter LOS
(4.3 versus 11.6 days, p<0.01), and lower incidence of
post-procedural stroke (1.0% versus 1.8%, p<0.01), acute
kidney injury (14.9% versus 24.8%, p<0.01), bleeding (4.3%
versus 47.1%, p<0.01), need for blood transfusion (2.9%
versus 18.5%, p<0.01), acute respiratory failure (10.7%
versus 19.8%, p<0.01), and total hospital charges (120,590$
versus 229,917$, p<0.01). These results persist after
adjustment for baseline characteristics. In a subgroup analysis, SR
mortality benefit persisted in patients who had multivessel
revascularization (in both ST and non-ST elevation AMI), but not in
single vessel revascularization.