PMID- 33734047
OWN - NLM
STAT- MEDLINE
DCOM- 20210322
LR  - 20210322
IS  - 0022-9040 (Print)
IS  - 0022-9040 (Linking)
VI  - 61
IP  - 2
DP  - 2021 Mar 6
TI  - Influence of Total Ischemic Time on Clinical Outcomes in Patients with ST-Segment 
      Elevation Myocardial Infarction.
PG  - 40-46
LID - 10.18087/cardio.2021.2.n1314 [doi]
AB  - Aim      To evaluate the effect of the total time of myocardial ischemia on 
      results of the treatment of patients with ST segment elevation acute myocardial 
      infarction (STEMI) who underwent percutaneous coronary interventions 
      (PCI).Material and methods This study used data from a hospital register for PCI 
      in STEMI from 2006 through 2017. 1649 patients were included. Group 1 consisted 
      of 604 (36.6 %) patients with a total time of myocardial ischemia not exceeding 
      1880 min; group 2 included 531 (32.2 %) patients with a duration of myocardial 
      ischemia from 180 to 360 min; and group 3 included 514 (31.2 %) patients with a 
      duration of myocardial ischemia longer than 360 min.Results Mortality was lower 
      in group 1 (2.3 %) than in groups 2 and 3 (6.2 and 7.2 %, respectively; 
      p1-2=0.001; p1-3<0.001; p2-3=0.520). The incidence of major cardiac 
      complications ("adverse cardiac events", MACE) was lower in group 1 (4.1 %) than 
      in groups 2 and 3 (7.3 and 9.5 %, respectively, p1-2=0.020; p1-3<0.001; 
      p2-3=0.200). The incidence of no-reflow phenomenon was higher in group 3 (9.7 %) 
      than in groups 2 and 3 (4.5 and 5.3 %, respectively (p1-2=0.539; p1-3=0.001; 
      p2-3=0.005). The major factors associated with the increased total time of 
      myocardial ischemia >180 min were age (odd ratio, OR, 1.01 at 95 % confidence 
      interval, CI, 1.0 to 1.02; small er, Cyrillic=0.044), female gender (OR, 1.64 at 95 % CI 1.26 to 
      2.13; small er, Cyrillic<0.001), chronic kidney disease (OR 1.82 at 95 % CI 1.21 to 2.74; 
      small er, Cyrillic=0.004). Performing prehospital thrombolysis was associated with a decrease in 
      the total time of myocardial ischemia (OR 0.4 at 95 % CI 0.31 to 0.51; 
      small er, Cyrillic<0.001). A strong direct correlation was observed between the total time of 
      myocardial ischemia and the time from the onset of pain syndrome to 
      hospitalization (r=0.759; small er, Cyrillic<0.001).Conclusion      The total time of 
      myocardial ischemia >180 min was associated with increased mortality and 
      development of MACE. The total time of myocardial ischemia > 360 min was 
      associated with increased incidence of the no-reflow phenomenon. The major 
      predictors for the time of myocardial ischemia >180 min included age, female 
      gender, and chronic kidney disease. The use of pharmacoinvasive strategy was 
      associated with an increased number of patients with a total duration of 
      myocardial ischemia <180 min. The contribution of the time of prehospital 
      delay to the total time of myocardial ischemia was greater than the contribution 
      of the "door-to-balloon" time. The time of prehospital delay showed a strong 
      direct correlation with the total time of myocardial ischemia.
FAU - Bessonov, I S
AU  - Bessonov IS
AD  - Tyumen Cardiology Research Center, Tomsk National Research Medical Center, 
      Russian Academy of Science, Tomsk.
FAU - Kuznetsov, V A
AU  - Kuznetsov VA
AD  - Tyumen Cardiology Research Center, Tomsk National Research Medical Center, 
      Russian Academy of Science, Tomsk.
FAU - Gorbatenko, E A
AU  - Gorbatenko EA
AD  - Tyumen Cardiology Research Center, Tomsk National Research Medical Center, 
      Russian Academy of Science, Tomsk.
FAU - Dyakova, A O
AU  - Dyakova AO
AD  - Tyumen Cardiology Research Center, Tomsk National Research Medical Center, 
      Russian Academy of Science, Tomsk.
FAU - Sapozhnikov, S S
AU  - Sapozhnikov SS
AD  - Tyumen Cardiology Research Center, Tomsk National Research Medical Center, 
      Russian Academy of Science, Tomsk.
LA  - rus
LA  - eng
PT  - Journal Article
DEP - 20210306
PL  - Russia (Federation)
TA  - Kardiologiia
JT  - Kardiologiia
JID - 0376351
SB  - IM
MH  - *Coronary Artery Disease
MH  - Female
MH  - Humans
MH  - *Myocardial Infarction/diagnosis/epidemiology/therapy
MH  - *No-Reflow Phenomenon
MH  - *Percutaneous Coronary Intervention
MH  - *ST Elevation Myocardial Infarction/diagnosis/epidemiology/surgery
MH  - Treatment Outcome
EDAT- 2021/03/19 06:00
MHDA- 2021/03/23 06:00
CRDT- 2021/03/18 12:32
PHST- 2020/08/06 00:00 [received]
PHST- 2020/11/24 00:00 [accepted]
PHST- 2020/11/11 00:00 [revised]
PHST- 2021/03/18 12:32 [entrez]
PHST- 2021/03/19 06:00 [pubmed]
PHST- 2021/03/23 06:00 [medline]
AID - 10.18087/cardio.2021.2.n1314 [doi]
PST - epublish
SO  - Kardiologiia. 2021 Mar 6;61(2):40-46. doi: 10.18087/cardio.2021.2.n1314.