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

BACKGROUND: Studies 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 f...

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Autores principales: Tödt, Tim, Maret, Eva, Alfredsson, Joakim, Janzon, Magnus, Engvall, Jan, Swahn, Eva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359186/
https://www.ncbi.nlm.nih.gov/pubmed/22361039
http://dx.doi.org/10.1186/1471-2261-12-9
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author Tödt, Tim
Maret, Eva
Alfredsson, Joakim
Janzon, Magnus
Engvall, Jan
Swahn, Eva
author_facet Tödt, Tim
Maret, Eva
Alfredsson, Joakim
Janzon, Magnus
Engvall, Jan
Swahn, Eva
author_sort Tödt, Tim
collection PubMed
description BACKGROUND: Studies 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. RESULTS: An 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. CONCLUSIONS: In 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.
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spelling pubmed-33591862012-05-24 Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI Tödt, Tim Maret, Eva Alfredsson, Joakim Janzon, Magnus Engvall, Jan Swahn, Eva BMC Cardiovasc Disord Research Article BACKGROUND: Studies 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. RESULTS: An 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. CONCLUSIONS: In 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. BioMed Central 2012-02-23 /pmc/articles/PMC3359186/ /pubmed/22361039 http://dx.doi.org/10.1186/1471-2261-12-9 Text en Copyright ©2012 Tödt et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Tödt, Tim
Maret, Eva
Alfredsson, Joakim
Janzon, Magnus
Engvall, Jan
Swahn, Eva
Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI
title Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI
title_full Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI
title_fullStr Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI
title_full_unstemmed Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI
title_short Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI
title_sort relationship between treatment delay and final infarct size in stemi patients treated with abciximab and primary pci
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359186/
https://www.ncbi.nlm.nih.gov/pubmed/22361039
http://dx.doi.org/10.1186/1471-2261-12-9
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