title: Impact of ischemic time on post-infarction left ventricular function in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: BACKGROUND
  Myocardial necrosis is a time-dependent event. Nevertheless, clinical studies on association between ischemic time and left ventricle function showed inconsistent findings. Aim of current study is to evaluate the association between ischemic time and the post-infarction left ventricular function in ST-elevation myocardial infarction treated with primary PCI.
  
  
  METHODS
  In 2529 patients treated with primary PCI, left ventricular ejection fraction (LVEF) was measured before discharge (median day 4) by radionuclide ventriculography or by echocardiography if patients had atrial fibrillation. Ischemic time was calculated from symptom onset to first balloon inflation.
  
  
  RESULTS
  The correlation between ischemic time as continuous variable and LVEF was significant but weak (P=0.002, r=-0.062). The LVEF of patients in ischemic time intervals of >6, >3-6, and ≤3 h was 45.1±11.7%, 44.6±11.9%, and 43.2±12.2%, respectively (P=0.029). Adjusted odds ratio of the ischemic time intervals for LVEF<40% was 1.14 (95% CI 1.00-1.30). TIMI flow 0 before and TIMI flow 3 after PCI were related with both longer ischemic time and low LVEF.
  
  
  CONCLUSIONS
  Ischemic time was associated with post infarction LVEF in patients treated with primary PCI, although this association was weak. Initial TIMI flow and post-PCI TIMI flow played important role in impact of the ischemic time on the LVEF.
authors: Isala Klinieken, Department of Cardiology, Zwolle, The Netherlands.
authors: Sunanto
authors: S
authors: Ng
authors: Jan Paul
authors: JP
authors: Ottervanger
authors: Arnoud W J
authors: AW
authors: van 't Hof
authors: Menko-Jan
authors: MJ
authors: de Boer
authors: Stoffer
authors: S
authors: Reiffers
authors: Jan-Henk E
authors: JH
authors: Dambrink
authors: Jan C A
authors: JC
authors: Hoorntje
authors: A T Marcel
authors: AT
authors: Gosselink
authors: Harry
authors: H
authors: Suryapranata
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000503:physiopathology*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*