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急性冠脉综合征

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Clinical Characteristics and Outcomes of STEMI Patients With Cardiogenic Shock and Cardiac Arrest From Early Pharmacology to Recent Pharmacology Interventions in Acute Coronary Syndromes A randomised trial comparing two stent sizing strategies in coronary bifurcation treatment with bioresorbable vascular scaffolds - The Absorb Bifurcation Coronary (ABC) trial Prevalence of Coronary Vasospasm Using Coronary Reactivity Testing in Patients With Spontaneous Coronary Artery Dissection OPTIMAL USE OF LIPID-LOWERING THERAPY AFTER ACUTE CORONARY SYNDROMES: A Position Paper endorsed by the International Lipid Expert Panel (ILEP) Revascularization Strategies in STEMI with Multivessel Disease: Deciding on Culprit Versus Complete-Ad Hoc or Staged Comparison of the Preventive Efficacy of Rosuvastatin Versus Atorvastatin in Post-Contrast Acute Kidney Injury in Patients With ST-segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention Post-Discharge Bleeding and Mortality Following Acute Coronary Syndromes With or Without PCI The Prognostic Significance of Periprocedural Infarction in the Era of Potent Antithrombotic Therapy: The PRAGUE-18 Substudy Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial

Original Research2017 Apr 1;232:140-146.

JOURNAL:Int J Cardiol. Article Link

Analysis of reperfusion time trends in patients with ST-elevation myocardial infarction across New York State from 2004 to 2012

Al'Aref SJ, Wong SC, Minutello RM et al.

ABSTRACT


BACKGROUND - Registry-driven data have shown a significant decrease in door-to-balloon (DTB) times in patients with ST-elevation myocardial infarction (STEMI) receiving percutaneous coronary intervention (PCI). We sought to determine the trends in reperfusion times (symptom-onset to door (SOTD) and DTB times) in patients presenting with STEMI across New York State.


METHODS - We retrospectively examined 35,613 STEMI patients receiving PCI from 2004 to 2012 and compared median SOTD and DTB times across years. Patients with SOTD time >12h and DTB time >3h were excluded.


RESULTS - There was a statistically significant trend towards shorter DTB times (median DTB time of 83min (IQR 53, 116) in 2004 to a median DTB time of 59min (IQR 40, 78) in 2012, P<0.01 for trend) and SOTD times (median SOTD time of 127min (IQR 64, 241) in 2004 to a median SOTD time of 116min (IQR 60, 205) in 2012, P<0.01 for trend). In subgroup analysis, demographics and the presence of co-morbid conditions did not influence the trend in reperfusion times. However, women had longer reperfusion times than men in 2012. After adjusting for confounding variables, DTB was a significant predictor of in-hospital mortality (HR=1.04 (per 10minutes), P<0.01).


CONCLUSIONS There was a significant decrease in reperfusion times from 2004 to 2012 in STEMI patients across New York State. This trend was significant regardless of the presence of co-morbid conditions, although a significant gap in reperfusion times persists between men and women.


Copyright © 2017 Elsevier B.V. All rights reserved.