Ischemic time is a better predictor than door-to-balloon time for mortality and infarct size in ST-elevation myocardial infarction

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Amirreza SolhpourRichard W Smalling

Abstract

Current guidelines for ST-elevation myocardial infarction (STEMI) recommend early revascularization with optimal ischemic time (IT) < 120 min and door-to-balloon (D2B) time < 90 min. The focus of most studies has been D2B time, while IT is not frequently reported. We tested the hypothesis that total IT is a better predictor than D2B time for mortality and infarct size. Between December 2008 and April 2013, 786 patients with STEMI were treated in our STEMI center, and 262 of these had cardiac magnetic resonance imaging 3-5 days after the index event. Total IT was defined as time from symptom onset to device activation, while D2B time was defined as hospital arrival to device activation. Patients were divided into three groups according to IT (<120, 120-239, ≥240 min) and into four groups according to D2B time (<30, 30-59, 60-89, ≥90 min). Baseline demographics including age, cardiac risk factors, and LAD infarct location were similar between groups. The 30-day mortality rate significantly increased across IT groups but did not correlate with D2B time groups. Similarly, infarct size significantly increased across IT groups but did not correlate with D2B time groups. In STEMI patients, IT was a better predictor than D2B time for 3...Continue Reading

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Citations

Jun 17, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·M Rizwan Sardar, J Dawn Abbott
Oct 11, 2016·Journal of cardiology·Hyun Kuk KimUNKNOWN other Korea Acute Myocardial Infarction Registry Investigators
Dec 31, 2019·Scandinavian Cardiovascular Journal : SCJ·Thomas LindowUlf Ekelund
Jul 16, 2020·Journal of Clinical Medicine·Sebastian J ReinstadlerBernhard Metzler
Oct 30, 2021·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Sanam KhowajaMusa Karim

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