WFRF:(Henning Thomas)
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Impact of diagnostic ECG-to-wire delay in STEMI patients treated with primary PCI : A DANAMI-3 substudy
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- Nepper-Christensen, Lars (författare)
- Copenhagen University Hospital
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- Lønborg, Jacob (författare)
- Copenhagen University Hospital
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- Høfsten, Dan Eik (författare)
- Copenhagen University Hospital
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- (creator_code:org_t)
- 2018
- 2018
- Engelska 8 s.
- Ingår i: EuroIntervention. - 1774-024X. ; 14:6, s. 700-707
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Aims: We aimed to evaluate the impact of delay from diagnostic pre-hospital electrocardiogram (ECG) to wiring of the infarct-related vessel (ECG-to-wire) >120 minutes on cardiovascular magnetic resonance (CMR) markers of reperfusion success and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: We included 1,492 patients in the analyses of clinical outcome. CMR was performed in 748 patients to evaluate infarct size and myocardial salvage. In total, 304 patients (20%) had ECG-to-wire >120 minutes, which was associated with larger acute infarct size (18% [interquartile range (IQR), 10-28] vs. 15% [8-24]; p=0.022) and smaller myocardial salvage (0.42 [IQR 0.28-0.57] vs. 0.50 [IQR 0.34-0.70]; p=0.002). However, 33% of the patients with ECG-to-wire >120 minutes still had a substantial myocardial salvage ≥0.50. In a multivariable analysis, ECG-to-wire >120 minutes was associated with an increased risk of all-cause mortality and heart failure (hazard ratio 1.61, 95% confidence interval [CI] 1.14-2.26, p=0.007). Conclusions: ECG-to-wire >120 minutes was associated with larger infarct size, smaller myocardial salvage and a poorer clinical outcome in STEMI patients transferred for primary percutaneous coronary intervention. However, myocardial salvage was still substantial in one third of patients treated beyond 120 minutes of delay.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Clinical research
- MRI
- Myocardial infarction
- STEMI
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