| Circadian variation in myocardial perfusion and mortality in patients with ST-segment elevation myocardial infarction treated by primary angioplasty. | |
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MedLine Citation:
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PMID: 16338256 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Little is known about whether the physiological factors that determine the circadian variation in ST-segment elevation myocardial infarction (STEMI) onset and thrombolysis efficacy may affect myocardial perfusion and long-term outcome of patients with STEMI treated with primary angioplasty. METHODS: Our study population consisted of 1548 consecutive patients with STEMI treated by primary angioplasty between April 1997 and October 2001. All clinical, angiographic, and follow-up data were collected. RESULTS: Most of the patients (65.2%) were treated at daytime (between 8 AM and 8 PM). Patients treated between 1 PM and midnight had a lower prevalence of anterior infarction and longer door-to-balloon time, whereas the shortest ischemic time and the largest use of stent were observed in patients treated between midnight and 4 AM Patients treated between 4 and 8 AM showed the worst outcome in terms of myocardial perfusion, enzymatic infarct size, and 1-year outcome, whereas patients treated between 8 AM and 4 PM had the best myocardial perfusion and lowest 1-year mortality rate. After correction for baseline confounding factors, the time of treatment (between 4 and 8 AM) was still significantly associated with 1-year mortality (relative risk 1.92, 95% CI 1.13-3.26, P = .016). CONCLUSIONS: This is the first study showing a significant relationship between the time of treatment, myocardial perfusion, and long-term mortality in patients with STEMI undergoing mechanical reperfusion. |
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Authors:
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Giuseppe De Luca; Harry Suryapranata; Jan Paul Ottervanger; Arnoud W J van 't Hof; Jan C A Hoorntje; A T Marcel Gosselink; Jan-Henk E Dambrink; Felix Zijlstra; Menko-Jan de Boer |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 150 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2005-12-12 Completed Date: 2006-02-14 Revised Date: 2007-08-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 1185-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, ISALA Klinieken, Hospital De Weezenlanden, Zwolle, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty / mortality* Circadian Rhythm / physiology* Coronary Angiography Electrocardiography Female Humans Male Middle Aged Myocardial Infarction / mortality, physiopathology*, radiography, surgery* Retrospective Studies Survival Analysis Treatment Outcome |
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