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Association of duration of symptoms at presentation with angiographic and clinical outcomes after fibrinolytic therapy in patients with st-segment elevation myocardial infarction

C. Michael Gibson, MS, MD^*,*, Sabina A. Murphy, MPH^*, Ajay J. Kirtane, MD^*,, Robert P. Giugliano, MD, SM^*, Christopher P. Cannon, MD^*, Elliott M. Antman, MD^*, Eugene Braunwald, MD^* TIMI Study Group

^* TIMI Study Group, Cardiovascular Division, Brigham & Women's Hospital
Cardiovascular Division, Beth Israel Deaconess Medical Center, Department of Medicine, Harvard Medical School, Boston, MassachusettsUSA

View larger version (24K): [in a new window]   Figure 1 Cumulative distribution function of time from symptom onset to treatment in hours.

View larger version (30K): [in a new window]   Figure 2 (A) Median time from symptom (sx) onset to treatment stratified by Thrombolysis In Myocardial Infarction myocardial perfusion grade (TMPG) at 60 min; (B) percent of patients with TMPG 2 or 3 at 60 min stratified by presentation >4 h from symptom onset versus 4 h from symptom onset; (C) blush brightness (gray scale) stratified by presentation >4 h from symptom onset versus4 h from symptom onset. DSA = digital subtraction angiography.

View larger version (30K): [in a new window]   Figure 3 (A) Median time from symptom onset to treatment by Thrombolysis In Myocardial Infarction flow grade (TFG) at 60 min; (B) percent of patients with TFG 2 or 3 at 60 min stratified by presentation >4 h from symptom onset versus 4 h from symptom onset; (C) median corrected TIMI frame count stratified by presentation >4 h from symptom onset versus 4 h from symptom onset.

View larger version (28K): [in a new window]   Figure 4 (A) Ejection fraction (%) stratified by presentation >4 h from symptom onset versus 4 h from symptom onset; (B) presence of collaterals (%) stratified by presentation >4 h from symptom onset versus 4 h from symptom onset.

View larger version (21K): [in a new window]   Figure 5 Median time from symptom (sx) onset to treatment stratified by post-percutaneous coronary intervention (PCI) Thrombolysis In Myocardial Infarction myocardial perfusion grade (TMPG).

View larger version (28K): [in a new window]   Figure 6 (A) Median time from symptom onset to treatment stratified by post-percutaneous coronary intervention Thrombolysis In Myocardial Infarction flow grade (TFG); (B) percent of patients with open/closed epicardial artery post-percutaneous coronary intervention stratified by presentation >4 h from symptom onset versus 4 h from symptom onset; (C) median corrected TIMI frame count post-percutaneous coronary intervention stratified by presentation >4 h from symptom onset versus 4 h from symptom onset.

View larger version (22K): [in a new window]   Figure 7 Clinical outcomes at 30 days stratified presentation >4 h from symptom onset versus 4 h from symptom onset. CHF = congestive heart failure; MI = myocardial infarction; OR = odds ratio.