| Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty. | |
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MedLine Citation:
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PMID: 13678918 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Giuseppe De Luca; Harry Suryapranata; Felix Zijlstra; Arnoud W J van 't Hof; Jan C A Hoorntje; A T Marcel Gosselink; Jan Henk Dambrink; Menko Jan de Boer; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 42 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2003 Sep |
Date Detail:
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Created Date: 2003-09-18 Completed Date: 2003-11-03 Revised Date: 2007-09-04 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 991-7 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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Angioplasty, Transluminal, Percutaneous Coronary* Female Humans Male Middle Aged Myocardial Infarction / diagnosis, mortality*, therapy* Time Factors |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2006 Sep 5;48(5):1062; author reply 1062-3
[PMID:
16949510
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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