CBS 2019
CBSMD教育中心
中 文

Acute Coronary Syndrom

Abstract

Recommended Article

Galectin-3 Levels and Outcomes After Myocardial Infarction: A Population-Based Study Systems of Care for ST-Segment–Elevation Myocardial Infarction: A Policy Statement From the American Heart Association Proportion and Morphological Features of Restenosis Lesions With Acute Coronary Syndrome in Different Timings of Target Lesion Revascularization After Sirolimus-Eluting Stent Implantation 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Association of Plaque Location and Vessel Geometry Determined by Coronary Computed Tomographic Angiography With Future Acute Coronary Syndrome–Causing Culprit Lesions Aggressive lipid-lowering therapy after percutaneous coronary intervention – for whom and how? Positive remodelling of coronary arteries on computed tomography coronary angiogram: an observational study 2023 ESC Guidelines for the management of acute coronary syndromes

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. Keywords: Mortality; Myocardial infarction; Reperfusion times

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.