Abstract
Aims: To determine the association between total ischemic time and in-hospital outcome of acute ST elevation myocardial infarction (STEMI) patients who underwent primary angioplasty.
 Study Design: Prospective observational study.
 Place & Duration of Study: Department of Cardiology, Dow university of health sciences Karachi between October 2017 till March 2021.
 Methodology: Data for total ischemic time analysis were collected from 366 STEMI patients who consecutively underwent primary angioplasty. Total ischemic time was measured from the onset of chest pain to o the first balloon inflation during primary angioplasty and in hospital outcome was measured.
 Results: Total ischemic times were available in 366 STEMI patients which was ≥ 30 minutes and < 24 hours: ≤ 2 hours in 15.5%, >2-3 hours in 11.4%, >3-5 hours in 25.4%, and >5 hours in 47.5% of STEMI patients. In addition, STEMI patients with total ischemic times <5 hours demonstrated complete ST-segment resolution and reduced death rate than those with total ischemic times >5 hours.
 Conclusion: This study showed that shorter ischemic times are significantly related to improved myocardial reperfusion and decreased mortality.
Highlights
According to the National Registry of Myocardial infarction (NRMI) database, it has been shown that those segment elevation myocardial infarction (STEMI) subjects who received early angioplasty are far more benefited in terms of inhospital mortality, length of stay, recurrent ischemia and cardiogenic shock compared to late ones [4,5]
Ischemic time was associated with presence of collateral redistribution, multi-vessel disease, stent implantation and use of Intra aortic balloon pump (IABP)
STEMI patients with early presentation did not need the use of IABP
Summary
Acute ST segment elevation myocardial infarction (STEMI) is increasingly becoming a dominant cardiovascular condition in bringing significant morbidity and mortality to vast majority of patients in developing countries [1]. We aimed at determining the association between total ischemic times and inhospital outcomes of acute STEMI patients who underwent primary angioplasty at Department of Cardiology of Dr Ruth K.M. Pfau, CHK during the period from October 2017 till March 2021. A structured pro-forma was filled out for the said subjects that encompasses continuous and categorical variables including age, gender, smoking history, diabetes, hypertension, dyslipidemia, location of myocardial infarction [anterior, inferior, lateral or posterior, and right ventricular infarction], total ischemic time (onsetto-door plus door-to-balloon time) which was systematically collected from patient itself or relatives of the patient, TIMI flow grade(pre and post procedure), number of diseased vessels, resolution of ST segment, and follow-up record at 30-day interval which was obtained through telephone or from hospital database. Microsoft Excel 2016 used to report the frequencies and percentages in tabulation and graphical format, as appropriate
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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
