CLINICAL RESEARCH: TREATMENT OF ACUTE INFARCTION WITH PCI
Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty
Giuseppe De Luca, MD*,
Harry Suryapranata, MD, PhD*,*,
Felix Zijlstra, MD, PhD, FACC*,
Arnoud W. J. van't Hof, MD, PhD*,
Jan C. A. Hoorntje, MD, PhD*,
A. T. Marcel Gosselink, MD, PhD*,
Jan-Henk Dambrink, MD, PhD*,
Menko-Jan de Boer, MD, PhD, FACC* ZWOLLE Myocardial Infarction Study Group
* Department of Cardiology, ISALA Klinieken, Hospital De Weezenlanden, Zwolle, Netherlands
Manuscript received April 16, 2003;
revised manuscript received May 13, 2003,
accepted May 21, 2003.
* Reprint requests and correspondence: Dr. Harry Suryapranata, ISALA Klinieken, Hospital De Weezenlanden, Department of Cardiology, Groot Wezeland 20, 8011 JW Zwolle, Netherlands.
h.suryapranata{at}diagram-zwolle.nl
OBJECTIVES: The aim of the study was to evaluate the relationship between symptom-onset-to-balloon time and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty.
BACKGROUND: Despite the prognostic implications demonstrated in patients with STEMI treated with thrombolysis, the impact of time-delay on prognosis in patients undergoing primary angioplasty has yet to be established.
METHODS: Our study population consisted of 1,791 patients with STEMI treated by primary angioplasty from 1994 to 2001. All clinical, angiographic and follow-up data were collected. Subanalyses were conducted according to patient risk profile at presentation and preprocedural Thrombolysis In Myocardial Infarction (TIMI) flow.
RESULTS: A total of 103 patients (5.8%) had died at one year. Symptom-onset-to-balloon time was significantly associated with the rate of postprocedural TIMI 3 flow (p = 0.012), myocardial blush grade (p = 0.033), and one-year mortality (p = 0.02). A stronger linear association between symptom-onset-to-balloon time and one-year mortality was observed in non-low-risk patients (p = 0.006) and those with preprocedural TIMI flow 0 to 1 (p = 0.013). No relationship was found between door-to-balloon time and mortality. At multivariate analysis, a symptom-onset-to-balloon time >4 h was identified as an independent predictor of one-year mortality (p < 0.05).
CONCLUSIONS: This study shows that, in patients with STEMI treated by primary angioplasty, symptom-onset-to-balloon time, but not door-to-balloon time, is related to mortality, particularly in non–low-risk patients and in the absence of preprocedural anterograde flow. Furthermore, a symptom-onset-to-balloon time >4 h was identified as independent predictor of one-year mortality.
|
Abbreviations and Acronyms
| | LDHQ48 | | enzymatic infarct size from serial measurements of lactate dehydrogenase | | MBG | | myocardial blush grade | | STEMI | | >ST-segment elevation myocardial infarction | | TIMI | | Thrombolysis In Myocardial Infarction |
|
This article has been cited by other articles:
|
|
|
|
 
F. Van de Werf
Year 2008 ESC ST-segment elevation myocardial infarction guidelines: implications for the interventional cardiologist--from evidence to recommendations and practice
Eur. Heart J. Suppl.,
June 1, 2009;
11(suppl_C):
C31 - C37.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. S Rathore, J. P Curtis, J. Chen, Y. Wang, B. K Nallamothu, A. J Epstein, H. M Krumholz, and for the National Cardiovascular Data Registry
Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study
BMJ,
May 19, 2009;
338(may19_1):
b1807 - b1807.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C J Terkelsen, E H Christiansen, J T Sorensen, S D Kristensen, J F Lassen, L Thuesen, H R Andersen, W Vach, and T T Nielsen
Primary PCI as the preferred reperfusion therapy in STEMI: it is a matter of time
Heart,
March 1, 2009;
95(5):
362 - 369.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Napodano, A. Ramondo, G. Tarantini, D. Peluso, S. Compagno, C. Fraccaro, A. C. Frigo, R. Razzolini, and S. Iliceto
Predictors and time-related impact of distal embolization during primary angioplasty
Eur. Heart J.,
February 1, 2009;
30(3):
305 - 313.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. W. Hamm, H. Möllmann, J.-P. Bassand, and F. van de Werf
CHAPTER 16 Acute Coronary Syndromes
ESC Textbook of Cardiovascular Medicine,
January 1, 2009;
2(1):
med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, F. Van de Werf, J. Bax, A. Betriu, C. Blomstrom-Lundqvist, F. Crea, V. Falk, G. Filippatos, K. Fox, K. Huber, et al.
Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology:
Eur. Heart J.,
December 1, 2008;
29(23):
2909 - 2945.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Glaser, S. S. Naidu, F. Selzer, A. K. Jacobs, W. K. Laskey, V. S. Srinivas, J. N. Slater, and R. L. Wilensky
Factors Associated With Poorer Prognosis for Patients Undergoing Primary Percutaneous Coronary Intervention During Off-Hours: Biology or Systems Failure?
J. Am. Coll. Cardiol. Intv.,
December 1, 2008;
1(6):
681 - 688.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. S. Kim, T. Y. Wang, D. Dai, A. J. Klein, E. D. Peterson, J. S. Rumsfeld, and J. C. Messenger
Association of Previous Coronary Artery Bypass Graft Surgery With Door-to-Balloon Time and In-Hospital Outcomes: A Report From the National Cardiovascular Data Registry (NCDR)
J. Am. Coll. Cardiol.,
November 11, 2008;
52(20):
1665 - 1670.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. W. Stone
Angioplasty Strategies in ST-Segment-Elevation Myocardial Infarction: Part I: Primary Percutaneous Coronary Intervention
Circulation,
July 29, 2008;
118(5):
538 - 551.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. G. Goodman, V. Menon, C. P. Cannon, G. Steg, E. M. Ohman, and R. A. Harrington
Acute ST-Segment Elevation Myocardial Infarction: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest,
June 1, 2008;
133(6_suppl):
708S - 775S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. H. Ting, E. H. Bradley, Y. Wang, J. H. Lichtman, B. K. Nallamothu, M. D. Sullivan, B. J. Gersh, V. L. Roger, J. P. Curtis, and H. M. Krumholz
Factors Associated With Longer Time From Symptom Onset to Hospital Presentation for Patients With ST-Elevation Myocardial Infarction
Arch Intern Med,
May 12, 2008;
168(9):
959 - 968.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. J. Brener, D. J. Moliterno, P. E. Aylward, A. W.J. van't Hof, W. Ruzyllo, W. W. O'Neill, C. W. Hamm, C. M. Westerhout, C. B. Granger, P. W. Armstrong, et al.
Reperfusion after primary angioplasty for ST-elevation myocardial infarction: predictors of success and relationship to clinical outcomes in the APEX-AMI Angiographic Study
Eur. Heart J.,
May 1, 2008;
29(9):
1127 - 1135.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J B Jones and A Docherty
Non-invasive treatment of ST elevation myocardial infarction
Postgrad. Med. J.,
December 1, 2007;
83(986):
725 - 730.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. K. Nallamothu, E. H. Bradley, and H. M. Krumholz
Time to Treatment in Primary Percutaneous Coronary Intervention
N. Engl. J. Med.,
October 18, 2007;
357(16):
1631 - 1638.
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. T Roberts and A. D Timmis
Patients with cardiac chest pain should call emergency services
BMJ,
September 29, 2007;
335(7621):
669 - 669.
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. N. Dhruva, S. I. Abdelhadi, A. Anis, W. Gluckman, D. Hom, W. Dougan, E. Kaluski, B. Haider, and M. Klapholz
ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction (STAT-MI) Trial
J. Am. Coll. Cardiol.,
August 7, 2007;
50(6):
509 - 513.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Huynh, J. O'Loughlin, L. Joseph, E. Schampaert, S. Rinfret, M. Afilalo, S. Kouz, B. Cantin, M. Nguyen, M. J. Eisenberg, et al.
Delays to reperfusion therapy in acute ST-segment elevation myocardial infarction: results from the AMI-QUEBEC Study
Can. Med. Assoc. J.,
December 5, 2006;
175(12):
1527 - 1532.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. S. Pinto, A. J. Kirtane, B. K. Nallamothu, S. A. Murphy, D. J. Cohen, R. J. Laham, D. E. Cutlip, E. R. Bates, P. D. Frederick, D. P. Miller, et al.
Hospital Delays in Reperfusion for ST-Elevation Myocardial Infarction: Implications When Selecting a Reperfusion Strategy
Circulation,
November 7, 2006;
114(19):
2019 - 2025.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P G Steg, J-P Cambou, P Goldstein, E Durand, P Sauval, Z Kadri, D Blanchard, J-M Lablanche, P Gueret, Y Cottin, et al.
Bypassing the emergency room reduces delays and mortality in ST elevation myocardial infarction: the USIC 2000 registry
Heart,
October 1, 2006;
92(10):
1378 - 1383.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Tarantini, R. Razzolini, and S. Iliceto
Interaction Among Risk-Time and Benefit of Primary Angioplasty
J. Am. Coll. Cardiol.,
September 5, 2006;
48(5):
1062 - 1062.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. A Ratner, R. Tzianetas, A. W Tu, J. L Johnson, M. Mackay, C. E Buller, M. Rowlands, and B. Reime
Myocardial infarction symptom recognition by the lay public: the role of gender and ethnicity.
J Epidemiol Community Health,
July 1, 2006;
60(7):
606 - 615.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Ortolani, A. Marzocchi, C. Marrozzini, T. Palmerini, F. Saia, C. Serantoni, M. Aquilina, S. Silenzi, F. Baldazzi, D. Grosseto, et al.
Clinical impact of direct referral to primary percutaneous coronary intervention following pre-hospital diagnosis of ST-elevation myocardial infarction
Eur. Heart J.,
July 1, 2006;
27(13):
1550 - 1557.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. L. McNamara, Y. Wang, J. Herrin, J. P. Curtis, E. H. Bradley, D. J. Magid, E. D. Peterson, M. Blaney, P. D. Frederick, H. M. Krumholz, et al.
Effect of Door-to-Balloon Time on Mortality in Patients With ST-Segment Elevation Myocardial Infarction
J. Am. Coll. Cardiol.,
June 6, 2006;
47(11):
2180 - 2186.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Kalla, G. Christ, R. Karnik, R. Malzer, G. Norman, H. Prachar, W. Schreiber, G. Unger, H. D. Glogar, A. Kaff, et al.
Implementation of Guidelines Improves the Standard of Care: The Viennese Registry on Reperfusion Strategies in ST-Elevation Myocardial Infarction (Vienna STEMI Registry)
Circulation,
May 23, 2006;
113(20):
2398 - 2405.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. D. Henry, J. M. Atkins, M. S. Cunningham, G. S. Francis, W. J. Groh, R. A. Hong, K. B. Kern, D. M. Larson, E. M. Ohman, J. P. Ornato, et al.
ST-Segment Elevation Myocardial Infarction: Recommendations on Triage of Patients to Heart Attack Centers: Is it Time for a National Policy for the Treatment of ST-Segment Elevation Myocardial Infarction?
J. Am. Coll. Cardiol.,
April 4, 2006;
47(7):
1339 - 1345.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. D. Banks and K. Dracup
Factors Associated With Prolonged Prehospital Delay of African Americans With Acute Myocardial Infarction
Am. J. Crit. Care.,
March 1, 2006;
15(2):
149 - 157.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. Garvey, B. A. MacLeod, G. Sopko, M. M. Hand, and on behalf of the National Heart Attack Alert Progr
Pre-Hospital 12-Lead Electrocardiography Programs: A Call for Implementation by Emergency Medical Services Systems Providing Advanced Life Support--National Heart Attack Alert Program (NHAAP) Coordinating Committee; National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health
J. Am. Coll. Cardiol.,
February 7, 2006;
47(3):
485 - 491.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. R. Brodie, C. Hansen, T. D. Stuckey, S. Richter, D. S. VerSteeg, N. Gupta, W. E. Downey, and M. Pulsipher
Door-to-Balloon Time With Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Impacts Late Cardiac Mortality in High-Risk Patients and Patients Presenting Early After the Onset of Symptoms
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
289 - 295.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. P. Wharton Jr, E. C. Keeley, C. L. Grines, T. P. Wharton Jr, E. C. Keeley, and C. L. Grines
The Case for Community Hospital Angioplasty
Circulation,
November 29, 2005;
112(22):
3509 - 3534.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Part 5: Acute Coronary Syndromes
Circulation,
November 29, 2005;
112(22_suppl):
III-55 - III-72.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Thiele, L. Engelmann, K. Elsner, M. J. Kappl, W.-H. Storch, K. Rahimi, A. Hartmann, D. Pfeiffer, G. D. Kneissl, D. Schneider, et al.
Comparison of pre-hospital combination-fibrinolysis plus conventional care with pre-hospital combination-fibrinolysis plus facilitated percutaneous coronary intervention in acute myocardial infarction
Eur. Heart J.,
October 1, 2005;
26(19):
1956 - 1963.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Beygui and G. Montalescot
The use of GP IIb/IIIa inhibitors into new perspectives: pre-catheterization laboratory administration
Eur. Heart J. Suppl.,
October 1, 2005;
7(suppl_I):
I10 - I14.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Migliorini and D. Antoniucci
Patient selection bias in primary percutaneous coronary intervention trials: a critical issue
Eur. Heart J. Suppl.,
October 1, 2005;
7(suppl_I):
I21 - I26.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P G Steg and J-M Juliard
Primary percutaneous coronary intervention in acute myocardial infarction: time, time, and time!
Heart,
August 1, 2005;
91(8):
993 - 994.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R Zahn, A Vogt, U Zeymer, A K Gitt, K Seidl, M Gottwik, M A Weber, W Niederer, B Modl, H-J Engel, et al.
In-hospital time to treatment of patients with acute ST elevation myocardial infarction treated with primary angioplasty: determinants and outcome. Results from the registry of percutaneous coronary interventions in acute myocardial infarction of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausarzte
Heart,
August 1, 2005;
91(8):
1041 - 1046.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H R Andersen, C J Terkelsen, L Thuesen, L R Krusell, S D Kristensen, H E Botker, J F Lassen, and T T Nielsen
Myocardial infarction centres: the way forward
Heart,
June 1, 2005;
91(suppl_3):
iii12 - iii15.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. De Luca, H. Suryapranata, G. W. Stone, D. Antoniucci, J. E. Tcheng, F.-J. Neumann, F. Van de Werf, E. M. Antman, and E. J. Topol
Abciximab as Adjunctive Therapy to Reperfusion in Acute ST-Segment Elevation Myocardial Infarction: A Meta-analysis of Randomized Trials
JAMA,
April 13, 2005;
293(14):
1759 - 1765.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Authors/Task Force Members, S. Silber, P. Albertsson, F. F. Aviles, P. G. Camici, A. Colombo, C. Hamm, E. Jorgensen, J. Marco, J.-E. Nordrehaug, et al.
Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology
Eur. Heart J.,
April 2, 2005;
26(8):
804 - 847.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Gersh, G. W. Stone, H. D. White, and D. R. Holmes Jr
Pharmacological Facilitation of Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: Is the Slope of the Curve the Shape of the Future?
JAMA,
February 23, 2005;
293(8):
979 - 986.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. M. Gibson, S. A. Murphy, A. J. Kirtane, R. P. Giugliano, C. P. Cannon, E. M. Antman, E. Braunwald, and TIMI Study Group
Association of duration of symptoms at presentation with angiographic and clinical outcomes after fibrinolytic therapy in patients with st-segment elevation myocardial infarction
J. Am. Coll. Cardiol.,
September 1, 2004;
44(5):
980 - 987.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. C. Keeley and C. L. Grines
Primary Percutaneous Coronary Intervention for Every Patient with ST-Segment Elevation Myocardial Infarction: What Stands in the Way?
Ann Intern Med,
August 17, 2004;
141(4):
298 - 304.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Writing Committee Members, E. M. Antman, D. T. Anbe, P. W. Armstrong, E. R. Bates, L. A. Green, M. Hand, J. S. Hochman, H. M. Krumholz, F. G. Kushner, et al.
ACC/AHA guidelines for the management of patients with ST-Elevation myocardial infarction--executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction)
J. Am. Coll. Cardiol.,
August 4, 2004;
44(3):
671 - 719.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. M. Antman, D. T. Anbe, P. W. Armstrong, E. R. Bates, L. A. Green, M. Hand, J. S. Hochman, H. M. Krumholz, F. G. Kushner, G. A. Lamas, et al.
ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)
Circulation,
August 3, 2004;
110(5):
588 - 636.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Montalescot, M. Borentain, L. Payot, J. P. Collet, and D. Thomas
Early vs Late Administration of Glycoprotein IIb/IIIa Inhibitors in Primary Percutaneous Coronary Intervention of Acute ST-Segment Elevation Myocardial Infarction: A Meta-analysis
JAMA,
July 21, 2004;
292(3):
362 - 366.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. M. Gibson and A. Schomig
Coronary and Myocardial Angiography: Angiographic Assessment of Both Epicardial and Myocardial Perfusion
Circulation,
June 29, 2004;
109(25):
3096 - 3105.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. De Luca, A. W.J van't Hof, M.-J. de Boer, J. P. Ottervanger, J. C.A Hoorntje, A.T.M. Gosselink, J.-H. E Dambrink, F. Zijlstra, and H. Suryapranata
Time-to-treatment significantly affects the extent of ST-segment resolution and myocardial blush in patients with acute myocardial infarction treated by primary angioplasty
Eur. Heart J.,
June 2, 2004;
25(12):
1009 - 1013.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. M. Antman and F. Van de Werf
Pharmacoinvasive Therapy: The Future of Treatment for ST-Elevation Myocardial Infarction
Circulation,
June 1, 2004;
109(21):
2480 - 2486.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. De Luca, H. Suryapranata, J. P. Ottervanger, and E. M. Antman
Time Delay to Treatment and Mortality in Primary Angioplasty for Acute Myocardial Infarction: Every Minute of Delay Counts
Circulation,
March 16, 2004;
109(10):
1223 - 1225.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
