PMID- 18386707
OWN - NLM
STAT- MEDLINE
DCOM- 20080430
LR  - 20101118
IS  - 0125-2208 (Print)
IS  - 0125-2208 (Linking)
VI  - 90
IP  - 12
DP  - 2007 Dec
TI  - Importance of delayed perfusion with primary angioplasty on short-term mortality 
      in acute myocardial infarction patients.
PG  - 2587-96
AB  - BACKGROUND: Early primary coronary interventions (PCI) in acute ST elevation 
      myocardial infarction (STEMI) is associated with improved outcome and mortality 
      rate but delayed reperfusion especially after 6 hours is still doubtful in terms 
      of clinical benefits because most myocardial muscle are infarcted after 6 hours 
      of onset of chest pain. OBJECTIVE: The aim of the present study was to compare 
      the mortality rate of patients treated with PCI within 6 hours of symptom onset 
      to those treated between 6 to 24 hours after the onset of STEMI. MATERIAL AND 
      METHOD: The present study included consecutive patients from the data of the Fast 
      Track Registry of King Chulalongkorn Hospital from June 1, 1999 to October 31, 
      2003 to compare the thirty-day mortality of patients treated with early or 
      delayed PCI (0-6 hours vs. 6-24 hours after symptom of chest pain) for STEMI. 
      RESULTS: Two hundred and sixteen patients who underwent PCI were enrolled. Male 
      gender (82% vs. 64.9%, p = 0.03) and history of smoking (72.1% vs. 50%, p = 0.04) 
      were predominant in the early treatment group (ETG) vs. the delayed treatment 
      group (DTG). Mean age (60.5% vs. 61.03%, p = 0.11), diabetes (31.4% vs. 29.7%, p 
      = 0.82), hypertension (64.0% vs. 54.1%, p = 0.20), dyslipidemia (58.1% vs. 60.8%, 
      p = 0.73), and ejection fraction < 40% (22.8% vs. 32.0%, p = 0.625) were similar 
      in both groups. There were no differences in angiographic finding and hospital 
      management. Door to balloon and total delay time were 124.13 +/- 143.27 min and 
      407.94 +/- 268.183 min, respectively. The thirty-day mortality (9.01% vs. 12.76%, 
      p = 0.379) and I year mortality (12.4% vs. 16 9%, p = 0.532) were not 
      significantly determined by Log rank test in both groups. As for cardiogenic 
      shock, ETG tended to have a lower thirty-day mortality than DTG but no 
      statistically significant difference (12.5% vs. 50.0%, p = 0.0809). CONCLUSION: 
      The delayed PCI up to 24 hours in STEMI does not increase short-term mortality at 
      thirty days; therefore, it may still have benefit in STEMI patients. However it 
      tended to have higher short-term mortality than early PCI especially in 
      cardiogenic shock but showed no statistical significance.
FAU - Kruthkul, Khanat
AU  - Kruthkul K
AD  - Division of Cardiovascular Disease, Department ofMedicine, King Chulalongkorn 
      Memorial Hospital, Bangkok, Thailand.
FAU - Srimahachota, Suphot
AU  - Srimahachota S
FAU - Udayachalerm, Wasan
AU  - Udayachalerm W
FAU - Budhari, Wacin
AU  - Budhari W
FAU - Charipromprasit, Jarkarun
AU  - Charipromprasit J
FAU - Suitthichayakul, Taworn
AU  - Suitthichayakul T
FAU - Sitthi-amorn, Chitr
AU  - Sitthi-amorn C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Thailand
TA  - J Med Assoc Thai
JT  - Journal of the Medical Association of Thailand = Chotmaihet thangphaet
JID - 7507216
SB  - IM
MH  - Acute Disease
MH  - *Angioplasty, Balloon
MH  - *Angioplasty, Balloon, Coronary
MH  - Female
MH  - Health Status Indicators
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/physiopathology/*therapy
MH  - Myocardial Reperfusion/*methods/mortality
MH  - Perfusion/*methods
MH  - Prospective Studies
MH  - Time Factors
MH  - *Treatment Outcome
EDAT- 2008/04/05 09:00
MHDA- 2008/05/01 09:00
CRDT- 2008/04/05 09:00
PHST- 2008/04/05 09:00 [pubmed]
PHST- 2008/05/01 09:00 [medline]
PHST- 2008/04/05 09:00 [entrez]
PST - ppublish
SO  - J Med Assoc Thai. 2007 Dec;90(12):2587-96.