Abstract
Early infarct-related artery (IRA) patency is associated with better clinical outcomes in STEMI patients. Using the FAST-MI 2010 ST-elevation myocardial infarction (STEMI) cohort, we investigated factors related to IRA patency (TIMI 2/3 flow) at the start of procedure in patients admitted for primary percutaneous coronary intervention (PCI). FAST-MI 2010 is a nationwide French registry including 4,169 Acute MI patients. Of 1452 STEMI patients with primary PCI, 466 (32%) had TIMI 2/3 flow of IRA before the procedure. Mean age (62±14 years in both groups), GRACE score (141±31 vs 142±34) and time from onset to angiography (472±499 vs 451±479min) did not differ according to IRA patency (TIMI2/3 vs TIMI 0/1). Using multivariate logistic regression analysis, IRA patency was more frequently found in patients having called earlier (<75min, median time from symptom onset: OR: 1.60; 95% CI 1.26-2.04), or receiving antiplatelet therapy (APT) before angiography. Increasing time from diagnostic ECG to angiography was also associated with IRA patency (>90min, OR: 1,38; 95%IC 1.08-1.77). The results were confirmed by propensity score analyses. Pre-procedural IRA patency is observed in one third of STEMI patients; it is more frequently found in patients having received APT prior to angiography, as well as in patients having called early. Higher IRA patency with increasing time delays from qualifying ECG to angiography suggests an additional role of spontaneous or medication-mediated fibrinolysis.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call