title: Time-to-treatment and infarct size in STEMI patients undergoing primary angioplasty.
abstract: BACKGROUND
  Several reports have shown that in patient with ST-segment elevation acute myocardial infarction (STEMI) longer ischemia time is associated with impaired reperfusion and higher mortality. However, there is still some doubts with regards time to reperfusion role in patients treated with primary percutaneous coronary intervention (PCI). Therefore, the aim of the current study was to evaluate the impact of time-to-treatment on infarct size as evaluated by myocardial scintigraphy in a large cohort of STEMI patients undergoing primary PCI.
  
  
  METHODS
  Our population is represented by 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99m-sestamibi.
  
  
  RESULTS
  Time-to-treatment was significantly associated with age and dyslipidemia. Time-to-treatment linearly affected the rate of postprocedural TIMI 3 flow (p<0.0001) and scintigraphic infarct size (p<0.001). The impact of time-to-treatment on infarct size persisted in the analysis restricted to patients with postpocedural TIMI 3 flow, and after correction for confounding factors such as age, dyslipidemia, postprocedural TIMI 3 flow (OR [95% CI]=1.26 [1.14-1.39], p<0.001).
  
  
  CONCLUSIONS
  This study shows in a large population of STEMI patients undergoing primary PCI that time-to-treatment is linearly associated with infarct size.
authors.affiliation: Division of Cardiology, Maggiore della Carità Hospital, Eastern Piedmont University, Novara, Italy. g.deluca@diagram-zwolle.nl
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
authors.forename: Guido
authors.initials: G
authors.lastname: Parodi
authors.forename: Roberto
authors.initials: R
authors.lastname: Sciagrà
authors.forename: Francesco
authors.initials: F
authors.lastname: Venditti
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bellandi
authors.forename: Ruben
authors.initials: R
authors.lastname: Vergara
authors.forename: Angela
authors.initials: A
authors.lastname: Migliorini
authors.forename: Renato
authors.initials: R
authors.lastname: Valenti
authors.forename: David
authors.initials: D
authors.lastname: Antoniucci
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011877:Radionuclide Imaging; D061665:Time-to-Treatment