Influence of treatment delay on long-term left ventricular function in patients with acute myocardial infarction successfully treated with primary angioplasty

Sheiban, Imad; Fragasso, Gabriele; Lu, Chunzeng; Tonni, S.; Trevi, Gian Paolo; Chierchia, Sergio

doi:10.1067/mhj.2001.113575

Cited by 15 publications

(10 citation statements)

References 45 publications

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“…19,22,23) If the duration of ischaemia does not exceed 4 hours, further significant improvement may be expected even within 6 months. 20) Our final check-up at 6 months from randomisation showed improved EF outcomes in groups B and C. This improvement was statistically significant in group B patients only. WMSI changes were at the limit of statistical significance.…”

Section: Discussionmentioning

confidence: 89%

“…19) Prior studies have established an unequivocal relationship between the duration of ischaemia and the extent of myocardial injury. 19,20) The relationship between ischaemia duration and left ventricular function, however, remains ambiguous. Some data suggest that a shorter duration of ischaemia results in less compromise of left ventricular function in the following days and weeks.…”

Section: Discussionmentioning

confidence: 99%

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Inter-hospital Transport for Primary Angioplasty Does Not Compromise Left Ventricular Function

et al. 2003

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SUMMARYThe main aim of the present study was to investigate whether long distance interhospital transport for primary angioplasty (delayed mechanical reperfusion) influences the resulting left ventricular function after myocardial infarction as compared with thrombolysis at the nearest hospital (immediate pharmacological reperfusion).Primary coronary angioplasty is more effective than thrombolysis in restoring coronary flow in patients with acute myocardial infarction. It is not known whether a delay in reperfusion due to transport to an angioplasty centre compromises left ventricular function, and whether combination therapy (ie, thrombolysis during transport to an angioplasty centre) would help preserve ejection fraction.The "PRAGUE-1" Study randomised 300 patients with myocardial infarction admitted to community hospitals without a cath-lab into 3 groups: group A (thrombolysis, no transport, n = 99), group B (thrombolysis during transport to an angioplasty centre, n = 100), and group C (transport for primary angioplasty, n = 101). Transport distances were below 75 kilometres, and mean transport time was 38 minutes. This paper presents for the first time the echocardiographic data from the early (discharge, day 30) and mid-term (6 months) follow-up. Only patients who survived until discharge (A: 85, B: 88, C: 94) could be analysed.Ejection fraction improved between discharge and 6 months (P < 0.01) in all three groups: from 47% to 51% in group A, from 47% to 52% in group B, and from 48% to 52% in group C. The differences between the groups were not significant. The same differences were found for the wall motion score index. Left ventricular end-diastolic diameter did not differ between the groups/examinations. Greater improvement was documented in the period between hospital discharge and day 30, compared to the period between day 30 and 6 months.The time delay associated with an inter-hospital transport strategy for primary angioplasty did not compromise left ventricular function. The strategy of thrombolysis during transport did not further improve left ventricular function compared to transport for priFrom

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Inter-hospital Transport for Primary Angioplasty Does Not Compromise Left Ventricular Function

et al. 2003

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“…Although reperfusion beyond 6 h can not save myocardium, it prevented the ventricular remodeling by prompting the healing of infarcted myocardium. Therefore, the cardiac systolic and diastolic function and wall movement and volume in group A are obviously better than in group D. When delayed PCI was performed, which missed the best chance to open infarct related artery, the infarction area will be bigger and there will be more severe ischemic injury at the edge, which contributed to the development of infarction enlargement [20].…”

Section: Discussionmentioning

confidence: 99%

Equilibrium radionuclide angiography for evaluating the effect of percutaneous coronary intervention on ventricular aneurysm formation and systolic synchrony in patients with acute myocardial infarction

Liu

et al. 2009

Int J Cardiovasc Imaging

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Left ventricular aneurysm (LVA) after myocardial infarction often results in serious complications. So far, when the LVA happened is unclear. Furthermore, it is a question whether percutaneous coronary intervention (PCI) can change or reverse the formation of LVA? And the report about the long term follow-up was rare. So this study was to evaluate the time sequence of the formation of LVA through left ventriculography in large scale of consecutive acute myocardial infarction (AMI) patients and evaluate the influence of PCI at different time after AMI on the change of systolic synchrony through phase analysis of equilibrium radionuclide angiography. The change of serum brain natriuretic peptide (BNP) was also measured to investigate its association with LVA. And follow up to 3 years to record the major adverse cardiac events. Total of 326 consecutive patients of anterior AMI with LVA were enrolled into this study. All patients were divided into four groups according to the time 'onset to balloon': group A (<3 h), group B (> or =3 and < or =6 h), group C (>6 and < or =12 h) and group D (>1 week). The paradox volume image as well as the parameters of left ventricular function and systolic synchrony were measured by equilibrium radionuclide angiography at 1 week and 6th month after AMI. Plasma BNP was measured in different time after AMI. The major adverse cardiac events were recorded up to 3 years. At the 6th month after AMI, left ventricular ejection fraction, peak ejection rate and peak filling rate in group A, B and C were significantly increased than those in group D while phase shift and peak phase standard deviation were decreased significantly (P < 0.05, respectively). At 6th month after AMI, the paradox volume index in group A was lowered than that in group B, C, and D (P < 0.05, respectively). In 18th hour, 5th day and 24th week after AMI, the values of BNP in group D were higher than those in group A, B and C (P < 0.05, respectively). There was not significantly different between group B and group C. Within the 3rd year follow-up, the incidences of angina post-AMI and mortality in group A, B, and C were significantly lowered than those in group D (P < 0.05, respectively). The LVA can formate shortly after the AMI. The early, fully and permanently patency of infraction related artery can effectively inhibit the left ventricular remodeling process, prevent LVA formation, improve its function and prognosis.

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“…However, a significant proportion of patients with STEMI presents to hospitals without PCI capability requiring transfer to PCI‐capable hospitals. Depending on travel distances, availability of transport, and weather conditions, transfer for primary PCI may cause significant delays in obtaining myocardial reperfusion, which can limit the benefit of primary PCI over FT in high‐risk cases . In comparison to patients presenting directly to a PCI‐capable center, those who require inter‐hospital transfer to a PCI‐capable hospital have significantly longer total door‐to‐balloon times (D2B).…”

Section: Introductionmentioning

confidence: 99%

Variability in Maximal Suggested Door‐in‐Door‐out Time for Hospitals Transferring Patients for Primary Angioplasty in STEMI

Harjai

Orshaw

Yaeger

et al. 2013

J Interven Cardiology

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Influence of treatment delay on long-term left ventricular function in patients with acute myocardial infarction successfully treated with primary angioplasty

Cited by 15 publications

References 45 publications

Inter-hospital Transport for Primary Angioplasty Does Not Compromise Left Ventricular Function

Inter-hospital Transport for Primary Angioplasty Does Not Compromise Left Ventricular Function

Equilibrium radionuclide angiography for evaluating the effect of percutaneous coronary intervention on ventricular aneurysm formation and systolic synchrony in patients with acute myocardial infarction

Variability in Maximal Suggested Door‐in‐Door‐out Time for Hospitals Transferring Patients for Primary Angioplasty in STEMI

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