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Total procedure time can determine long-term prognosis in acute ST-segment elevation myocardial infarction Patients

Session Poster session 3

Speaker Ae-Young Her

Event : ESC Congress 2016

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes: Post-Infarction Period
  • Session type : Poster Session

Authors : Y H Kim (Chuncheon,KR), S-W Rha (Seoul,KP), A-Y Her (Chuncheon,KR), BG Choi (Seoul,KP), SH Park (Seoul,KP), CU Choi (Seoul,KP), CG Park (Seoul,KP), HS Seo (Seoul,KP), DJ Oh (Seoul,KP), SY Choi (Seoul,KP), JK Byun (Seoul,KP), H Li (Seoul,KP), S-H Park (Cheonan-si,KR), JY Park (Daejeon,KR), JH Ahn (Gumi,KR)

Authors:
Y.H. Kim1 , S.-W. Rha2 , A.-Y. Her1 , B.G. Choi2 , S.H. Park2 , C.U. Choi2 , C.G. Park2 , H.S. Seo2 , D.J. Oh2 , S.Y. Choi2 , J.K. Byun2 , H. Li2 , S.-H. Park3 , J.Y. Park4 , J.H. Ahn5 , 1Kangwon National University School of Medicine - Chuncheon - Korea Republic of , 2Korea University Guro Hospital - Seoul - Korea Republic of , 3Soonchunhyang University Hospital - Cheonan - Korea Republic of , 4Eulji University - Seoul - Korea Republic of , 5Soon Chun Hyang University Gumi Hospital - Gumi - Korea Republic of ,

Citation:
European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 576

Background: Door-to-balloon time has been a well-known standard process metric in the treatment of ST-segment elevation myocardial infarction (STEMI) by primary percutaneous coronary intervention (PPCI). However, limited data are available for long-term prognosis of the total procedure time in STEMI patients (pts) after PPCI. We investigated the clinical significance and long-term prognostic effect of total procedure time during PPCI in STEMI ps.

Method: A total 4,241 consecutive pts underwent PCI between April 2003 and December 2010 were enrolled; among them, 777 pts were presented with STEMI. After excluding cardiogenic shock, multi-vessel disease, bifurcation lesion (≥2vessel), fibrinolysis and chronic total occlusion lesion, 523 pts were included for the analysis. We investigated the association between total procedure time and major clinical outcomes including death, recurrent myocardial infarction (re-MI), target lesion revascularization (TLR) and target vessel revascularization (TVR) and major adverse cardiovascular events (MACE) defined as a composite of death, re-MI, TLR and TVR up to 5 years.

Results: At 5-year follow-up, total procedure time, age and renal dysfunction were associated with higher risk of MACE (Table). Further, total procedure time was independently associated with MI (OR 1.011; 95% CI, 1.002–1.020; p=0.020), TLR (OR 1.014; 95% CI, 1.004–1.025, p=0.008) and TVR (OR 1.102; 95% CI, 1.003–1.022; p=0.012).

Conclusion: Total procedure time at the time of PPCI was an important determinant of MACE, MI, TLR and TVR in STEMI pts.

Independent predictors of MACE at 5 years in STEMI patients
MACE
Hazard ratio (95% Confidence interval)P-value
Total procedure time (min)1.008 (1.000–1.016)0.047
Age1.025 (1.004–1.047)0.021
Gender0.715 (0.397–1.2880.264
Previous MI0.904 (0.94–8.714)0.930
Previous peripheral vascular disease0.192 (0.021–1.739)0.142
Estimated GFR <60 mL/min/m25.548 (1.926–15.984)0.002

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