title: Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI.
abstract: BACKGROUND
  Studies on the impact of time to treatment on myocardial infarct size have yielded conflicting results. In this study of ST-Elevation Myocardial Infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), we set out to investigate the relationship between the time from First Medical Contact (FMC) to the demonstration of an open infarct related artery (IRA) and final scar size.Between February 2006 and September 2007, 89 STEMI patients treated with primary PCI were studied with contrast enhanced magnetic resonance imaging (ceMRI) 4 to 8 weeks after the infarction. Spearman correlation was computed for health care delay time (defined as time from FMC to PCI) and myocardial injury. Multiple linear regression was used to determine covariates independently associated with infarct size.
  
  
  RESULTS
  An occluded artery (Thrombolysis In Myocardial Infarction, TIMI flow 0-1 at initial angiogram) was seen in 56 patients (63%). The median FMC-to-patent artery was 89 minutes. There was a weak correlation between time from FMC-to-patent IRA and infarct size, r = 0.27, p = 0.01. In multiple regression analyses, LAD as the IRA, smoking and an occluded vessel at the first angiogram, but not delay time, correlated with infarct size.
  
  
  CONCLUSIONS
  In patients with STEMI treated with primary PCI we found a weak correlation between health care delay time and infarct size. Other factors like anterior infarction, a patent artery pre-PCI and effects of reperfusion injury may have had greater influence on infarct size than time-to-treatment per se.
authors.affiliation: Department of Medical and Health Sciences, Division of Cardiology, Linköping University, Linköping, Sweden. timtodt64@gmail.com
authors.forename: Tim
authors.initials: T
authors.lastname: Tödt
authors.forename: Eva
authors.initials: E
authors.lastname: Maret
authors.forename: Joakim
authors.initials: J
authors.lastname: Alfredsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Janzon
authors.forename: Jan
authors.initials: J
authors.lastname: Engvall
authors.forename: Eva
authors.initials: E
authors.lastname: Swahn
mesh_terms: D000077284:Abciximab; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D009204:Myocardial Revascularization / Q000379:methods*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab