Primary Percutaneous Angioplasty. An Analysis of Reperfusion Delays, Their Determining Factors, and Their Prognostic Implications
| Autor: | Luis Nombela, Susana Mingo, Javier Ortigosa, Raymundo Ocaranza, Ana Blasco, Yolanda Romero, Isabel Millán, Luis Alonso-Pulpón, Javier Goicolea, Elena Sufrate, José Antonio Fernández-Díaz |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Multivariate analysis medicine.medical_treatment Myocardial Ischemia Ischemia Myocardial Reperfusion Risk Factors Interquartile range Angioplasty Internal medicine medicine Humans Myocardial infarction Angioplasty Balloon Coronary Aged Interventional cardiology business.industry Percutaneous coronary intervention General Medicine Middle Aged Prognosis medicine.disease Surgery Transportation of Patients Spain Conventional PCI Cardiology Female business |
| Zdroj: | Revista Española de Cardiología (English Edition). 62:15-22 |
| ISSN: | 1885-5857 |
| DOI: | 10.1016/s1885-5857(09)71509-9 |
| Popis: | The optimum treatment for patients with ST-segment elevation acute myocardial infraction (AMI) is primary percutaneous coronary intervention (PCI), provided that the door-to-balloon time is less than 90 min. The aims of this study were to determine actual treatment times in our patients, to investigate the effect of different factors in reducing those times, and to evaluate the impact of any delay on prognosis.The study involved patients who underwent primary or rescue PCI at our center between January 2005 and October 2007. Treatment times, clinical and angiographic characteristics, and follow-up findings at 1 and 12 months were recorded prospectively.Overall, 389 PCIs were performed: 361 primary and 28 rescue interventions. The median total duration of ischemia was 235 [interquartile range, 170-335] min. The median door-to-balloon time was 79 [53-104] min. The door-to-balloon time was shorter when the ambulance service was able to notify the on-duty cardiologist, who alerted the interventional cardiology team. The difference was 30 [60-90] min (P.01). Patients who arrived at the emergency department by their own means had the longest door-to-balloon time (100 min vs. 74 min; P.01). A door-to-balloon time120 min was associated with higher mortality at 30 days; multivariate analysis showed a clearly increasing trend.The door-to-balloon time at our center was in line with current recommendations, with the time being markedly shorter for patients for whom the ambulance service was able to give advanced warning. A shorter time was associated with a trend towards lower 30-day mortality. |
| Databáze: | OpenAIRE |
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