Document Detail


Influence of treatment delay on infarct size and clinical outcome in patients with acute myocardial infarction treated with primary angioplasty.
MedLine Citation:
PMID:  9741503     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this analysis was to determine the influence of an additional treatment delay inherent in transfer to an angioplasty center for primary angioplasty of patients with acute myocardial infarction who are first admitted to hospitals without angioplasty facilities. BACKGROUND: Several randomized trials have demonstrated the benefits of primary angioplasty in acute myocardial infarction. In recent years, increasing numbers of patients with myocardial infarction, initially admitted to hospitals without angioplasty facilities are transported to our hospital for primary angioplasty. However, the additional delay due to the transport may have a deleterious effect on infarct size and clinical outcome. METHODS: In a three-year period (December 1993 to November 1996), 207 consecutive patients who were transferred for primary angioplasty were analyzed in a matched comparison with non-transferred patients. Matching criteria were age, sex, infarct location, presentation delay and Killip class. RESULTS: Patients who were transferred had an additional median delay of 43 min. This resulted in a more extensive enzymatic infarct size and a lower ejection fraction measured at 6 months. The rate of angioplasty success defined as TIMI grade 3 flow, and the 6-month mortality rate (7%) were comparable in both groups. CONCLUSIONS: The additional delay had a deleterious effect on myocardial salvage, reflected by a larger infarct size and a lower left ventricular function. However, the patency rate and 6-month clinical outcome were not affected by this delay.
Authors:
A L Liem; A W van 't Hof; J C Hoorntje; M J de Boer; H Suryapranata; F Zijlstra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  32     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-28     Completed Date:  1998-09-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  629-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hospital de Weezenlanden, Zwolle, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Electrocardiography*
Female
Humans
L-Lactate Dehydrogenase / blood
Male
Middle Aged
Myocardial Infarction / diagnosis,  physiopathology,  therapy*
Netherlands
Patient Transfer*
Prognosis
Prospective Studies
Retrospective Studies
Time Factors
Treatment Outcome
Ventricular Function, Left / physiology*
Chemical
Reg. No./Substance:
EC 1.1.1.27/L-Lactate Dehydrogenase
Comments/Corrections
Comment In:
J Am Coll Cardiol. 1999 Jun;33(7):2087-8   [PMID:  10362221 ]

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