PMID- 28134127
OWN - NLM
STAT- MEDLINE
DCOM- 20180306
LR  - 20180306
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 13
IP  - 1
DP  - 2017 May 15
TI  - Impact of presentation and transfer delays on complete ST-segment resolution 
      before primary percutaneous coronary intervention: insights from the ATLANTIC 
      trial.
PG  - 69-77
LID - EIJ-D-16-00965 [pii]
LID - 10.4244/EIJ-D-16-00965 [doi]
AB  - AIMS: The aim of this study was to identify predictors of complete ST-segment 
      resolution (STR) pre-primary percutaneous coronary intervention (PCI) in patients 
      enrolled in the ATLANTIC trial. METHODS AND RESULTS: ECGs recorded at the time of 
      inclusion (pre-hospital [pre-H]-ECG) and in the catheterisation laboratory before 
      angiography (pre-PCI-ECG) were analysed by an independent core laboratory. 
      Complete STR was defined as >/=70%. Complete STR occurred pre-PCI in 12.8% 
      (204/1,598) of patients and predicted lower 30-day composite MACCE (OR=0.10, 95% 
      CI: 0.002-0.57, p=0.001) and total mortality (OR=0.16, 95% CI: 0.004-0.95, 
      p=0.035). Independent predictors of complete STR included the time from index 
      event to pre-H-ECG (OR=0.94, 95% CI: 0.89-1.00, p=0.035), use of heparins before 
      pre-PCI-ECG (OR=1.75, 95% CI: 1.25-2.45, p=0.001) and time from pre-H-ECG to 
      pre-PCI-ECG (OR=1.09, 95% CI: 1.03-1.16, p=0.005). In the pre-H ticagrelor group, 
      patients with complete STR had a significantly longer delay between pre-H-ECG and 
      pre-PCI-ECG compared to patients without complete STR (median 53 [44-73] vs. 49 
      [38.5-61] mins, p=0.001); however, this was not observed in the control group 
      (in-hospital ticagrelor) (50 [40-67] vs. 49 [39-61] mins, p=0.258). CONCLUSIONS: 
      Short patient delay, early administration of anticoagulant and ticagrelor if a 
      long transfer delay is expected may help to achieve reperfusion prior to PCI. 
      Pre-H treatment may be beneficial in patients with longer transfer delays, 
      allowing the drug to become biologically active.
FAU - Fabris, Enrico
AU  - Fabris E
AD  - Cardiology Department, Isala Clinics, Zwolle, the Netherlands.
FAU - Van't Hof, Arnoud
AU  - Van't Hof A
FAU - Hamm, Christian W
AU  - Hamm CW
FAU - Lapostolle, Frederic
AU  - Lapostolle F
FAU - Lassen, Jens Flensted
AU  - Lassen JF
FAU - Goodman, Shaun G
AU  - Goodman SG
FAU - Ten Berg, Jurrien M
AU  - Ten Berg JM
FAU - Bolognese, Leonardo
AU  - Bolognese L
FAU - Cequier, Angel
AU  - Cequier A
FAU - Chettibi, Mohamed
AU  - Chettibi M
FAU - Hammett, Christopher H
AU  - Hammett CH
FAU - Huber, Kurt
AU  - Huber K
FAU - Janzon, Magnus
AU  - Janzon M
FAU - Merkely, Bela
AU  - Merkely B
FAU - Storey, Robert F
AU  - Storey RF
FAU - Zeymer, Uwe
AU  - Zeymer U
FAU - Cantor, Warren J
AU  - Cantor WJ
FAU - Rousseau, Helene
AU  - Rousseau H
FAU - Vicaut, Eric
AU  - Vicaut E
FAU - Montalescot, Gilles
AU  - Montalescot G
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty, Balloon, Coronary/adverse effects
MH  - Electrocardiography/methods
MH  - Emergency Medical Services/methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - *Percutaneous Coronary Intervention/adverse effects
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Risk Factors
MH  - *Thrombolytic Therapy/methods
MH  - Treatment Outcome
EDAT- 2017/01/31 06:00
MHDA- 2018/03/07 06:00
CRDT- 2017/01/31 06:00
PHST- 2017/01/31 06:00 [pubmed]
PHST- 2018/03/07 06:00 [medline]
PHST- 2017/01/31 06:00 [entrez]
AID - EIJ-D-16-00965 [pii]
AID - 10.4244/EIJ-D-16-00965 [doi]
PST - ppublish
SO  - EuroIntervention. 2017 May 15;13(1):69-77. doi: 10.4244/EIJ-D-16-00965.