Relation of mortality of primary angioplasty during acute myocardial infarction to door-to-Thrombolysis In Myocardial Infarction (TIMI) time

Am J Cardiol. 2003 Jun 15;91(12):1401-5. doi: 10.1016/s0002-9149(03)00388-6.

Abstract

For primary angioplasty of acute myocardial infarction (AMI), the relation of treatment benefit and time has been debated. The present study aimed to evaluate, in a single-center cohort of patients with ST-segment elevation AMI, which time intervals were carefully and consistently measured, and the relations among ischemic time, in-hospital delays, and in-hospital survival. We included 499 patients (mean age 59 years; 80% men) who underwent successful primary percutaneous transluminal coronary angioplasty (PTCA) for AMI admitted < or =6 hours after symptom onset. The population was divided into tertiles with respect to time between onset of symptoms and admission, onset of symptoms to Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow, and time from admission to TIMI grade 3 flow. Univariate analysis followed by multiple logistic regression was performed using the variables linked to mortality in the univariate analysis to assess the relation between predictor variables and in-hospital mortality. The in-hospital mortality rate was 3.2%. There was no significant relation between the various tertiles of time intervals and in-hospital mortality. After linear logistic regression, only age (odds ratio [OR] 1.79 per 10 years), female gender (OR 3.56), and door-to-TIMI 3 time (OR 1.27 per 15 minutes) were independently correlated with in-hospital mortality.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Abciximab
  • Aged
  • Angioplasty, Balloon, Coronary / mortality*
  • Antibodies, Monoclonal / therapeutic use
  • Anticoagulants / therapeutic use
  • Coronary Angiography
  • Electric Countershock
  • Female
  • Hospital Mortality
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality*
  • Myocardial Infarction / therapy*
  • Pain / diagnosis
  • Pain / epidemiology
  • Pain / etiology
  • Patient Admission
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prognosis
  • Risk Factors
  • Statistics as Topic
  • Thrombolytic Therapy
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Anticoagulants
  • Immunoglobulin Fab Fragments
  • Abciximab