Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction
Bruce R. Brodie, MD, FACCa,c,
Thomas D. Stuckey, MD, FACCa,c,
Thomas C. Wall, MD, FACCa,c,
Grace Kissling, PhD* c,
Charles J. Hansen, MAa,c,
Denise B. Muncy, BSNa,c,
Richard A. Weintraub, MD, FACCa,c and
Thomas A. Kelly, MD, FACCa,c
a Department of Medicine, The Moses H. Cone Memorial Hospital, The Department of Mathematical Sciences, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
* Department of Medicine, The Moses H. Cone Memorial Hospital, The Department of Mathematical Sciences, Division of Statistics, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
c LeBauer Cardiovascular Research Foundation, Greensboro, North Carolina, USA
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Figure 1 Thirty-day mortality and 30-day–plus late cardiac mortality versus time to reperfusion. Mortality was significantly less in the early reperfusion group (<2 h) versus the three later reperfusion groups combined. Mortality was relatively independent of time to reperfusion after 2 h. The p values compare the early perfusion group (<2 h) with the three later reperfusion groups combined ( 2 h).
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Figure 2 Multivariate predictors of 30-day mortality. The TIMI flow and cardiogenic shock were the strongest predictors of 30-day mortality. Late reperfusion (2 h) was a modest predictor.
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Figure 3 Kaplan–Meier survival curves for 30-day–plus late cardiac survival for each of four categories of time to reperfusion. Survival in the early reperfusion group (<2 h) was significantly better than in the three later reperfusion groups combined (p = 0.03 by log rank test). Survival was similar in the three later reperfusion groups, with no significant differences between groups.
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