Relationship between treatment delay and final infarct size in STEMI patients treated with abciximab and primary PCI

BMC Cardiovascular Disorders, 02/24/2012

In patients with ST–Elevation Myocardial Infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) authors found a weak correlation between health care delay time and infarct size. Other factors like anterior infarction, a patent artery pre–PCI and effects of reperfusion injury may have had greater influence on infarct size than time–to–treatment per se.

Methods

  • Between February 2006 and September 2007, 89 STEMI patients treated with primary PCI were studied with contrast enhanced magnetic resonance imaging (ceMRI) 4 to 8 weeks after the infarction.
  • Spearman correlation was computed for health care delay time (defined as time from FMC to PCI) and myocardial injury.
  • Multiple linear regression was used to determine covariates independently associated with infarct size.

Results

  • An occluded artery (Thrombolysis In Myocardial Infarction, TIMI flow 0–1 at initial angiogram) was seen in 56 patients (63%).
  • The median FMC–to–patent artery was 89 minutes.
  • There was a weak correlation between time from FMC–to–patent IRA and infarct size, r = 0.27, p = 0.01.
  • In multiple regression analyses, LAD as the IRA, smoking and an occluded vessel at the first angiogram, but not delay time, correlated with infarct size.

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