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Off-hours timing does not affect PCI outcomes

Off-hours presentation to the hospital with STEMI did not affect PCI outcomes in the international prospective randomized CHAMPION PHOENIX trial.

The newer findings are reassuring and, in contrast with findings from several previous retrospective registry–based studies, suggest that presenting to the hospital at night or on weekends or holidays is no more hazardous than presenting during regular working hours, Senthil Selvaraj, MD, said in a presentation at the annual congress of the European Society of Cardiology. The results may reflect global quality improvement measures in STEMI care.

In the study, which was simultaneously published in Journal of the American College of Cardiology, researchers assessed the outcomes of 1,992 patients with STEMI participating in a large, industry-sponsored clinical trial. The primary efficacy outcome – a combination of all-cause mortality, MI, stent thrombosis, or ischemia-driven revascularization at 48 hours – was no different between patients who presented at 7 a.m. through 7 p.m. Monday through Friday than in those who presented during off hours (RR, 1.00), said Dr. Selvaraj of Brigham and Women’s Hospital Heart & Vascular Center, Boston.

There also was no difference between the two study groups in the primary safety outcome, which was moderate to severe bleeding events.

PCI yielded consistent benefits regardless of the timing of patient presentation, Dr. Selvaraj said.

CHAMPION PHOENIX was sponsored by the Medicines Company.

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Off-hours presentation to the hospital with STEMI did not affect PCI outcomes in the international prospective randomized CHAMPION PHOENIX trial.

The newer findings are reassuring and, in contrast with findings from several previous retrospective registry–based studies, suggest that presenting to the hospital at night or on weekends or holidays is no more hazardous than presenting during regular working hours, Senthil Selvaraj, MD, said in a presentation at the annual congress of the European Society of Cardiology. The results may reflect global quality improvement measures in STEMI care.

In the study, which was simultaneously published in Journal of the American College of Cardiology, researchers assessed the outcomes of 1,992 patients with STEMI participating in a large, industry-sponsored clinical trial. The primary efficacy outcome – a combination of all-cause mortality, MI, stent thrombosis, or ischemia-driven revascularization at 48 hours – was no different between patients who presented at 7 a.m. through 7 p.m. Monday through Friday than in those who presented during off hours (RR, 1.00), said Dr. Selvaraj of Brigham and Women’s Hospital Heart & Vascular Center, Boston.

There also was no difference between the two study groups in the primary safety outcome, which was moderate to severe bleeding events.

PCI yielded consistent benefits regardless of the timing of patient presentation, Dr. Selvaraj said.

CHAMPION PHOENIX was sponsored by the Medicines Company.

Off-hours presentation to the hospital with STEMI did not affect PCI outcomes in the international prospective randomized CHAMPION PHOENIX trial.

The newer findings are reassuring and, in contrast with findings from several previous retrospective registry–based studies, suggest that presenting to the hospital at night or on weekends or holidays is no more hazardous than presenting during regular working hours, Senthil Selvaraj, MD, said in a presentation at the annual congress of the European Society of Cardiology. The results may reflect global quality improvement measures in STEMI care.

In the study, which was simultaneously published in Journal of the American College of Cardiology, researchers assessed the outcomes of 1,992 patients with STEMI participating in a large, industry-sponsored clinical trial. The primary efficacy outcome – a combination of all-cause mortality, MI, stent thrombosis, or ischemia-driven revascularization at 48 hours – was no different between patients who presented at 7 a.m. through 7 p.m. Monday through Friday than in those who presented during off hours (RR, 1.00), said Dr. Selvaraj of Brigham and Women’s Hospital Heart & Vascular Center, Boston.

There also was no difference between the two study groups in the primary safety outcome, which was moderate to severe bleeding events.

PCI yielded consistent benefits regardless of the timing of patient presentation, Dr. Selvaraj said.

CHAMPION PHOENIX was sponsored by the Medicines Company.

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Key clinical point: Off-hours presentation to the hospital with STEMI didn’t affect PCI outcomes in a large international trial.

Major finding: The combined outcome of all-cause mortality, MI, stent thrombosis, or ischemia-driven revascularization at 48 hours was no different between patients who presented at 7 a.m. through 7 p.m. Monday through Friday than in those who presented off-hours (RR, 1.00).

Data source: An industry-sponsored propensity-matched international trial involving 1,992 patients presenting with STEMI.

Disclosures: This study was sponsored by The Medicines Company and also supported by Chiesi. Dr. Selvaraj reported having no relevant financial disclosures; his associates reported ties to numerous industry sources.