Relation of mortality of primary angioplasty during acute myocardial infarction to door-to-Thrombolysis In Myocardial Infarction (TIMI) time.
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.
Juliard
Jean-Michel
JM
Cardiology Department, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75877 Paris Cedex 18, France. jean-michel.juliard@bch.ap-hop-paris.fr
Feldman
Laurent J
LJ
Golmard
Jean-Louis
JL
Himbert
Dominique
D
Benamer
Hakim
H
Haghighat
Tinouche
T
Karila-Cohen
Daniel
D
Aubry
Pierre
P
Vahanian
Alec
A
Steg
Ph Gabriel
PG
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
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab