title: Effect of transfer delay on left ventricular function after primary PCI for ST elevation myocardial infarction.
abstract: BACKGROUND
  Primary PCI (PPCI) is superior to thrombolysis for treatment of acute ST Elevation Myocardial Infarction (STEMI). However, transfer to a PCI centre results in a treatment delay compared to those presenting directly to such hospitals. The aim of this study was to investigate the influence of transfer delay on LV function and clinical outcomes in PPCI patients.
  
  
  METHODS
  Of 113 consecutive PPCI patients, 69 presented directly to the PCI centre and 44 were transferred. Echocardiography was performed at day 1 and after 6 weeks to assess LV function using the Wall Motion Score Index (WMSI). Patients were followed for a mean of 3.51 years.
  
  
  RESULTS
  There was no significant difference in WMSI at day 1 between local and transfer patients (1.52±0.36 and 1.48±0.34 respectively, p=ns). After 6 weeks the WMSI improved significantly in both groups (1.33±0.33 and 1.31±0.31 respectively, p<0.001 for both). On multivariate analysis, pain to balloon time>160 min, LAD stenosis and initial TIMI flow 0-1 were significant independent predictors of LV dysfunction. There was no significant difference in clinical events during long term follow up.
  
  
  CONCLUSIONS
  Patients transferred for PPCI had similar LV function and clinical outcomes compared to those who presented directly to a PCI hospital.
authors.affiliation: Department of Cardiology, The Canberra Hospital, Garran, ACT 2606, Australia. afarshid@tpg.com.au
authors.forename: Ahmad
authors.initials: A
authors.lastname: Farshid
authors.forename: Leonard
authors.initials: L
authors.lastname: Arnolda
authors.forename: Bruce
authors.initials: B
authors.lastname: Shadbolt
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000601:surgery*; D010360:Patient Transfer; D062645:Percutaneous Coronary Intervention; D016277:Ventricular Function, Left