title: Quality of myocardial reperfusion according to ischemic time and infarcted territory.
abstract: BACKGROUND
  The relationship of the ischemic time to primary angioplasty and the quality of myocardial reperfusion according to infarcted territory among patients with ST-segment elevation myocardial infarction (STEMI) is unclear.
  
  
  METHODS
  This study consisted of 140 patients with STEMI within 12 h from the symptom onset and undergoing a primary angioplasty from the Protection of Distal Embolization in High-Risk Patients with Acute ST-Segment Elevation Myocardial Infarction Trial. ST-segment resolution (STR) at 60 min was analyzed by an independent corelab using continuous ST monitoring. Patients were divided according to anterior (n=74) and nonanterior (n=64) locations and according to ischemic time in quartiles (<90, 90-148, 148-241, and 241-635 min).
  
  
  RESULTS
  Although there was no significant decrement in the extent of STR with the ischemic time in the entire population (74, 51, 72, and 51%, respectively, P=not significant), patients with anterior location have a significant reduction in the extent of STR after 90 min compared with those coming after 90 min (70.6 vs. 29.2% of complete STR, P=0.003, respectively).
  
  
  CONCLUSIONS
  Patients with anterior STEMI seem to have a stronger impact of ischemic time on the quality of myocardial reperfusion compared with patients with nonanterior location.
authors.affiliation: Department of Interventional Cardiology and Endovascular Therapeutics, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Cura
authors.forename: Mariano
authors.initials: M
authors.lastname: Albertal
authors.forename: Jorge
authors.initials: J
authors.lastname: Thierer
authors.forename: Alejandro Garcia
authors.initials: AG
authors.lastname: Escudero
authors.forename: Alfonsina
authors.initials: A
authors.lastname: Candiello
authors.forename: Samir
authors.initials: S
authors.lastname: Jozami
authors.forename: Pablo Perez
authors.initials: PP
authors.lastname: Baliño
authors.forename: Lucio T
authors.initials: LT
authors.lastname: Padilla
authors.forename: Marcelo
authors.initials: M
authors.lastname: Trivi
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Belardi
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D057505:Embolic Protection Devices; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D016017:Odds Ratio; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome