title: Relation of mortality of primary angioplasty during acute myocardial infarction to door-to-Thrombolysis In Myocardial Infarction (TIMI) time.
abstract: For primary angioplasty of acute myocardial infarction (AMI), the relation of treatment benefit and time has been debated. The present study aimed to evaluate, in a single-center cohort of patients with ST-segment elevation AMI, which time intervals were carefully and consistently measured, and the relations among ischemic time, in-hospital delays, and in-hospital survival. We included 499 patients (mean age 59 years; 80% men) who underwent successful primary percutaneous transluminal coronary angioplasty (PTCA) for AMI admitted < or =6 hours after symptom onset. The population was divided into tertiles with respect to time between onset of symptoms and admission, onset of symptoms to Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow, and time from admission to TIMI grade 3 flow. Univariate analysis followed by multiple logistic regression was performed using the variables linked to mortality in the univariate analysis to assess the relation between predictor variables and in-hospital mortality. The in-hospital mortality rate was 3.2%. There was no significant relation between the various tertiles of time intervals and in-hospital mortality. After linear logistic regression, only age (odds ratio [OR] 1.79 per 10 years), female gender (OR 3.56), and door-to-TIMI 3 time (OR 1.27 per 15 minutes) were independently correlated with in-hospital mortality.
authors.affiliation: Cardiology Department, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75877 Paris Cedex 18, France. jean-michel.juliard@bch.ap-hop-paris.fr
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Juliard
authors.forename: Laurent J
authors.initials: LJ
authors.lastname: Feldman
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Golmard
authors.forename: Dominique
authors.initials: D
authors.lastname: Himbert
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.forename: Tinouche
authors.initials: T
authors.lastname: Haghighat
authors.forename: Daniel
authors.initials: D
authors.lastname: Karila-Cohen
authors.forename: Pierre
authors.initials: P
authors.lastname: Aubry
authors.forename: Alec
authors.initials: A
authors.lastname: Vahanian
authors.forename: Ph Gabriel
authors.initials: PG
authors.lastname: Steg
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography; D004554:Electric Countershock; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D010343:Patient Admission; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D013223:Statistics as Topic; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab