What is false about Percutaneous Coronary Intervention (PCI): is it done within 90 minutes of Myocardial Infarction (MI), can still be done in 12 hours after MI, can still be done 24 hours after MI in cardiogenic shock, or is it contraindicated in severe heart failure?

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Last updated: February 18, 2025View editorial policy

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From the Guidelines

The statement that is false about Percutaneous Coronary Intervention (PCI) is that it is contraindicated in severe heart failure. In fact, PCI can be beneficial in patients with severe heart failure, particularly those with cardiogenic shock, as it can help restore coronary blood flow and improve cardiac function 1.

Key Points

  • PCI can be performed within 90 minutes of myocardial infarction (MI) as a systems goal when the patient presents to a hospital with PCI capability 1.
  • PCI can still be done up to 12 hours after MI, as primary PCI should be performed in patients within 12 hours of onset of STEMI 1.
  • PCI can even be done up to 24 hours after MI in patients with cardiogenic shock, as primary PCI should be performed in patients with STEMI who develop severe heart failure or cardiogenic shock and are suitable candidates for revascularization as soon as possible, irrespective of time delay 1.
  • The benefits of PCI in severe heart failure, particularly cardiogenic shock, include restoring coronary blood flow and improving cardiac function, which can lead to better outcomes and reduced mortality 1.

Important Considerations

  • The systems goal of performing primary PCI within 90 minutes of first medical contact when the patient presents to a hospital with PCI capability, and within 120 minutes when the patient presents to a hospital without PCI capability, should be followed 1.
  • The decision to perform PCI in patients with severe heart failure or cardiogenic shock should be made on a case-by-case basis, taking into account the individual patient's circumstances and the potential benefits and risks of the procedure 1.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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