Post-infectious myocardial Infarction: Does percutaneous coronary intervention improve outcomes? A propensity-score matched analysis

Abstract

Acute infection is a frequent trigger of myocardial infarction (MI). However, whether percutaneous coronary intervention (PCI) improves post-infectious MI prognosis is a major but unsolved issue. We aimed to determine whether PCI at the acute phase of post-infectious MI (PIMI) in patients with angiography-proven coronary stenosis is associated with short and long-term outcome. Prospective observational study of PIMI in the RICO Survey from 2012 to 2017. Among 4573 consecutive MI patients, 476 patients (10%) were PIMI, of whom 375 underwent coronary angiography and 321 patients had a significant stenosis (> 50%). Patients who underwent PCI within the first 48 hours of hospitalization were compared with patients without PCI. In-hospital and one-year mortality (follow-up for 99% of patients) after propensity-score matching, based on clinical and angiographic data. Among the 321 patients, 195 underwent PCI. Before matching procedure, patients without PCI had higher rate of risk factors (hypertension, diabetes, chronic renal failure, and prior coronary artery disease), pneumonia and SYNTAX score than patients without PCI. After propensity score matching, neither in hospital mortality (13% with PCI vs. 8% without PCI; P = .4) nor 1-year mortality (24% with PCI vs. 19% without PCI, P = .5) significantly differed between the 2 groups. In this first prospective cohort of post-infectious MI in coronary care units, PCI might not improve short and long-term prognosis. If confirmed, these results do not claim for systematic invasive procedures after post-infectious MI.