Role of Angiographic Perfusion Score in Prediction of Perfusion Success and Risk Stratification Following Primary PCI versus Pharmaco-Invasive PCI for Anterior STEMI

Background: When a susceptible coronary atherosclerotic plaque is damaged, myocardial infarction in the ST segment occurs. The angiographic perfusion score (APS) compares the primary Percutaneous Coronary Intervention (PCI) clinical outcome for a STEMI patient to the pharmaco-invasive PCI. Aim: to assess the short-term clinical outcomes between primary PCI and pharmaco-invasive PCI in a STEMI patient. Methods: Eighty individuals who presented within the first day of onset of symptoms and were diagnosed with anterior STEMI underwent this prospective observational research. The patients were separated into two groups of equivalent size: Group II was treated with streptokinase, a fibrinolytic agent, at a hospital that was unable to perform PCI before being moved to a PCI-capable center that performed PCI within 3 to 24 hours. Group I got primary PCI. Results: There were no statistically significant differences between the groups receiving fibrinolytic therapies and primary PCI as regards ejection fraction (EF%) and SWMI pre and post-treatment, with a substantial increase in APS-raised thrombolysis in myocardial infarction (TIMI) in Group II, and minimized tissue myocardial perfusion grade (TMPG) than group I. The univariate analysis illustrated that history of diabetes (COR=3.13), decrease in EF, pre-treatment (COR=0.694), increase in SWMI pre (COR=533.89), and reduction in APS (COR=0.413) were Major adverse cardiac events (MACE) estimations that are statistically noteworthy. Multivariate analysis illustrated that EF and APS are statistically significant predictors affecting MACE among studied cases (AOR=10.15 & 0.662). Conclusions: APS is a more accurate indicator of perfusion success and a good predictor of MACE in anterior STEMI patients after primary PCI or pharmaco-invasive treatment.