Journal article
How does delaying treatment affect the long-term prognosis for patients with acute myocardial infarction treated with primary coronary angioplasty?
Kardiologia polska (1957), Vol.61(8), pp.91-100; discussion 100
08/01/2004
PMID: 15457275
Abstract
BACKGROUNDThe benefit of thrombolysis in patients with acute myocardial infarction (AMI) strongly depends on the time from the onset of symptoms to the initiation of treatment. For AMI patients treated with percutaneous coronary interventions (PCI) this delay of treatment seems to be important only up to a certain time level.AIMTo assess the effects of time to treatment of AMI with PCI on the short- and long-term prognosis.METHODSWe followed 339 consecutive AMI patients treated with PCI from 1995 to 1999 in our centre. Patients were divided into five groups according to the time to treatment and ischaemic time (time from symptom onset to reperfusion).RESULTSTime to treatment <90 min was achieved in 35 (10.5%) patients; 91-210 min in 105 (31%); 211-330 min in 72 (21%); 331-690 min in 74 (22%); and >691 min in 53 (15.5%) patients. According to ischaemic time, the patients were divided into groups: <2 h, 2-4 h, 4-6 h, 6-12 h, and >12 h. The ejection fraction of the left ventricle 3-5 days after AMI was 50%, 51%, 45%, 40%, and 46%, and the 30 day mortality - 5.7%, 2.9%, 11.1%, 10.8%, and 11.3%, respectively. Compared with patients treated later, patients with time to treatment <3.5 h had a significantly higher rate of TIMI 3 flow (93.6% vs 83.9%, p=0.007), lower 30-day mortality (3.6% vs 11.1%, p=0.012), lower 3-year mortality (8.6% vs 19.1%, p=0.003), lower frequency of heart failure during hospitalisation (11.4% vs 28.1%, p<0.001) as well as lower maximal level of creatine kinase (32+/-29 vs 44+/-39 micro kat/l, p=0.005).CONCLUSIONSThe success rate of primary PCI to achieve normal flow in an infarct-related artery is high, but it decreases when treatment is started later than 3,5 h from AMI onset. The short-term and long-term mortality as well as the incidence of heart failure during the acute phase of MI are the lowest when PCI is started within 3,5 h from the onset of symptoms.
Details
- Title: Subtitle
- How does delaying treatment affect the long-term prognosis for patients with acute myocardial infarction treated with primary coronary angioplasty?
- Creators
- Stanisław SimekJ C LubandaM AschermannJ HumhalJ HorkT KovarnikM PsenikaL GolanV DanzigV Mrazek
- Resource Type
- Journal article
- Publication Details
- Kardiologia polska (1957), Vol.61(8), pp.91-100; discussion 100
- PMID
- 15457275
- ISSN
- 0022-9032
- Language
- English
- Date published
- 08/01/2004
- Academic Unit
- Electrical and Computer Engineering
- Record Identifier
- 9984627205602771
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