Characteristics, management and outcome of patients with late-arrival STEMI in the Acute Coronary Syndrome Israeli Surveys (ACSIS).

Autor:	Tarabih M; Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel., Ovdat T; The Israeli Center for Cardiovascular Research, Sheba Medical Center, Tel Aviv, Israel., Karkabi B; Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel., Barel MS; Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel., Muhamad M; Department of Cardiology, Haemek Medical Center, Afula, Israel., Beigel R; Department of Cardiology, Sheba Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel., Orvin K; Department of Cardiology, Rabin Medical Center, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel., Shiran A; Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel., Eitan A; Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2024 Jul 27; Vol. 53, pp. 101476. Date of Electronic Publication: 2024 Jul 27 (Print Publication: 2024).
DOI:	10.1016/j.ijcha.2024.101476
Abstrakt:	Introduction: Patients with ST-elevation myocardial infarction (STEMI) and late arrival (>12 h) after symptom onset, are at high risk for mortality and heart failure and represent a challenge for management. We aimed to define patient characteristics, management, and outcome of late-arrival STEMI in Israel over the last 20 years. Methods: We analyzed data of late-arrival STEMI (12-48 h and > 48 h) from the biennial acute coronary syndrome Israeli Surveys (ACSIS), as well as time-dependent changes [early (2000-2010) Vs. late (2013-2021) period]. Results: Data regarding time from symptom onset to hospital arrival was available in 6,466 STEMI patients. Of these, 9.6 % arrived 12-48 h and 3 % >48 h from symptom onset. Late-arrival patients were more likely to be older women with diabetes and high GRACE score and less likely to have prior myocardial infarction.In recent years, 95 % of patients arriving 12-48 h and 96 % of those arriving > 48 h had coronary angiography, as opposed to 75 % and 77 % in the early years (p = 0.007). Percutaneous coronary intervention (PCI) increased from 60 % and 55 % respectively to 85 % (p ≤ 0.001).TIMI-3 flow after primary PCI was 89-92 %, irrespective of arrival time. Late arrival patients (12-48 h but not > 48 h) who had PCI had better adjusted 1-year survival, HR 0.49 (95 %CI 0.29-0.82), p = 0.01. Conclusions: Late-arrival STEMI patients have higher risk characteristics. Most late-arrival patients undergo coronary angiography and PCI and have TIMI-3 flow after primary PCI. In patients arriving 12-48 h after symptom onset PCI is associated with better survival. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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