Relationship between treatment delay and type of reperfusion therapy and mechanical complications of acute myocardial infarction

Objectives: The incidence of mechanical complications after acute myocardial infarction has markedly declined with the advent of reperfusion. Nevertheless there is some controversy about the equal effectiveness of the different reperfusion therapies in preventing these complications. We aimed to analyse how reperfusion therapy and treatment delay relate to the incidence of mechanical complications in a population of ST-elevation myocardial infarction (STEMI) patients. Methods: We analysed all STEMI patients included in the second phase of the Portuguese Registry on Acute Coronary Syndromes, between October 2010 and July 2015. We compared both conservative medical treatment with reperfusion therapy and thrombolysis with primary percutaneous coronary intervention for mechanical complications. We also evaluated the impact of treatment delay on mechanical complications. Results: Among 5230 STEMIs we observed 77 mechanical complications (1.5%). These were significantly more frequent in the non-reperfused patients (3.3% vs. 1.1%, P