TY - JOUR T1 - What is the real impact of on-site percutaneous coronary intervention? A propensity score matched analysis of patients admitted with Acute Coronary Syndrome JO - Revista Portuguesa de Cardiologia (English edition) T2 - AU - Miranda,Hugo AU - Sousa,Catarina AU - Santos,Hélder AU - Almeida,Inês AU - Chin,Joana AU - Almeida,Samuel AU - Tavares,João SN - 21742049 M3 - 10.1016/j.repce.2020.06.007 DO - 10.1016/j.repce.2020.06.007 UR - https://www.revportcardiol.org/en-what-is-real-impact-on-site-articulo-S2174204921000015 AB - IntroductionIn an era in which coronary heart disease is one of the leading causes of death worldwide, several studies report the persistence of obstacles to accessing revascularization, and percutaneous coronary intervention in particular, which may be associated with worse outcomes. ObjectivesTo compare cardiovascular outcomes in patients admitted to hospitals with and without on-site percutaneous coronary intervention (PCI) capabilities. Material and MethodsA retrospective study based on the National Registry of Acute Coronary Syndromes (ACS)—with data collection from 2010 to 2018. Division of the patients into two groups: with and without ST-elevation. Two subgroups were subsequently created according to the presence/absence of on-site PCI. A propensity score was performed to standardize the results. Patients without information about hospital admission (with/without PCI) were excluded. Results6008 patients were included after exclusion criteria and propensity score were applied. We found that patients admitted for ACS with ST-elevation (STE-ACS) had more episodes of sustained ventricular tachycardia (OR 2.14; CI (1.26−3.61); p=0.004) in hospitals without on-site PCI. Regarding ACS without ST elevation (NSTE-ACS), there were more cases of congestive heart failure (OR 0.79; CI (0.65−0.98)) in hospitals with on-site PCI. ConclusionThe incidence of a greater number of major adverse events in hospitalizations without on-site PCI, particularly in the case of STE-ACS, is a consequence of the delay before revascularization. National and local strategies must be established to reduce the negative impact of the absence of on-site PCI and the resulting time before revascularization. ER -