Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI

BMC Cardiovascular Disorders

Research Article

Jan Engvall¹  Eva Maret²  Eva Swahn³  Tim Tödt³  Magnus Janzon³  Joakim Alfredsson³ 

[1] Center for Medical Image Science and Visualization, Linköping University, SE-581 83, Linköping, Sweden;Department of Clinical Physiology UHL, County Council of Östergötland, SE-581 85, Linköping, Sweden;Department of Clinical Physiology, Ryhov County Hospital, SE-551 85Jönköping, Sweden;Center for Medical Image Science and Visualization, Linköping University, SE-581 83, Linköping, Sweden;Department of Medical and Health Sciences, Division of Cardiology, Linköping University, Linköping, Sweden, Department of Cardiology UHL, County Council of Östergötland, SE-581 85, Linköping, Sweden;

关键词: Angioplasty;    Balloon;    Coronary;    Emergency Medical Services;    Myocardial Infarction;    Myocardial Reperfusion;    Time Factors;    Time and Motion Studies;   

DOI  :  10.1186/1471-2261-12-9

 received in 2011-10-21, accepted in 2012-02-23,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundStudies on the impact of time to treatment on myocardial infarct size have yielded conflicting results. In this study of ST-Elevation Myocardial Infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), we set out to investigate the relationship between the time from First Medical Contact (FMC) to the demonstration of an open infarct related artery (IRA) and final scar size.Between February 2006 and September 2007, 89 STEMI patients treated with primary PCI were studied with contrast enhanced magnetic resonance imaging (ceMRI) 4 to 8 weeks after the infarction. Spearman correlation was computed for health care delay time (defined as time from FMC to PCI) and myocardial injury. Multiple linear regression was used to determine covariates independently associated with infarct size.ResultsAn occluded artery (Thrombolysis In Myocardial Infarction, TIMI flow 0-1 at initial angiogram) was seen in 56 patients (63%). The median FMC-to-patent artery was 89 minutes. There was a weak correlation between time from FMC-to-patent IRA and infarct size, r = 0.27, p = 0.01. In multiple regression analyses, LAD as the IRA, smoking and an occluded vessel at the first angiogram, but not delay time, correlated with infarct size.ConclusionsIn patients with STEMI treated with primary PCI we found a weak correlation between health care delay time and infarct size. Other factors like anterior infarction, a patent artery pre-PCI and effects of reperfusion injury may have had greater influence on infarct size than time-to-treatment per se.

【 授权许可】

CC BY   
© Tödt et al; licensee BioMed Central Ltd. 2012