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Dudek D, Dziewierz A, Rakowski T, et al. Time-to-reperfusion therapy influences outcome of patients with myocardial infarction subjected to facilitated PCI. EuroIntervention. 2005;1(3):309-14
Dudek, D., Dziewierz, A., Rakowski, T., El Masri, N., Sorysz, D., Zalewski, J., Legutko, J., Zmudka, K., Piwowarska, W., & Dubiel, J. S. (2005). Time-to-reperfusion therapy influences outcome of patients with myocardial infarction subjected to facilitated PCI. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 1(3), 309-14.
Dudek, Dariusz, et al. "Time-to-reperfusion therapy influences outcome of patients with myocardial infarction subjected to facilitated PCI." EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology vol. 1,3 (2005): 309-14.
Dudek D, Dziewierz A, Rakowski T, El Masri N, Sorysz D, Zalewski J, Legutko J, Zmudka K, Piwowarska W, Dubiel JS. Time-to-reperfusion therapy influences outcome of patients with myocardial infarction subjected to facilitated PCI. EuroIntervention. 2005 Nov;1(3):309-14. PMID: 19758922.
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EuroIntervention. 2005 Nov;1(3):309-14.

Time-to-reperfusion therapy influences outcome of patients with myocardial infarction subjected to facilitated PCI.

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology

Dariusz Dudek, Artur Dziewierz, Tomasz Rakowski, Nader El Masri, Danuta Sorysz, Jaroslaw Zalewski, Jacek Legutko, Krzysztof Zmudka, Wieslawa Piwowarska, Jacek S Dubiel

Affiliations

  1. Department of Interventional Cardiology, Institute of Cardiology, Medical College, Jagiellonian University, Krakow, Poland.

PMID: 19758922

Abstract

AIM: The purpose of this study was to evaluate the impact of time-to-reperfusion on outcome after facilitated percutaneous coronary intervention (PCI) i.e. PCI following early pharmacological reperfusion therapy in ST-segment elevation myocardial infarction (STEMI).

METHODS AND RESULTS: The study population consisted of 262 consecutive patients with STEMI, aged <75 years, without cardiogenic shock, presenting <12 hours of chest pain onset, transferred from community hospitals to a catheterization laboratory with time delay >90 min after pharmacological reperfusion therapy (alteplase i.v. bolus 15 mg followed by an infusion - 35 mg/60 min; abciximab i.v. bolus 0.25 mg/kg followed by a 12-hour infusion - 0.125 microg/kg/min; unfractionated heparin i.v. bolus 40 U/kg [maximum 3000 U]). One hundred seventeen patients (44.7%) received pharmacological reperfusion therapy <3 h after chest pain onset, 101 (38.5%) at 3-6 h and 44 patients (16.8%) >6 h. Patent infarct-related artery rates at initial angiography were similar among the study groups. PCI significantly improved epicardial flow in all three groups. Mortality at 12 months was significantly related to time-to-pharmacological reperfusion (3.4% [<3 h], 4.0% [3-6 h], 13.6% [>6 h], p = 0.027). At 6 months left ventricular ejection fraction was significantly improved in the two groups of patients with time-to-pharmacological reperfusion <6 hours and the time-to-pharmacological reperfusion was the independent predictor of lack of left ventricular ejection fraction recovery.

CONCLUSION: Our study shows that among STEMI patients undergoing facilitated PCI, time-to-pharmacological reperfusion significantly affects left ventricular function recovery and long-term mortality.

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