Outcome of Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention During On- Versus Off-hours (A Harmonizing Outcomes With RevasculariZatiON and Stents in Acute Myocardial Infarction [HORIZONS-AMI] Trial Substudy)

Cubeddu, Roberto J.; Palacios, Igor F.; Blankenship, James C.; Horvath, Sofia A.; Xu, Ke; Kovacic, Jason C.; Dangas, George; Witzenbichler, Bernhard; Guagliumi, Giulio; Kornowski, Ran; Dudek, Dariusz; Stone, Gregg W.; Mehran, Roxana

doi:10.1016/j.amjcard.2012.11.062

Cited by 35 publications

(35 citation statements)

References 23 publications

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“…Our results are congruent with previous reports from Netherlands and US [17,18], although others have reported different findings [7,9,10,19]. Even though regional differences in clinical praxis and organization of the health care system could explain these divergent outcomes, there are also important differences in study design.…”

Section: Discussionsupporting

confidence: 88%

Prognosis is similar for patients who undergo primary PCI during regular‐hours and off‐hours: A report from SCAAR*

Redfors

Dworeck

Angerås

et al. 2017

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 88%

Prognosis is similar for patients who undergo primary PCI during regular‐hours and off‐hours: A report from SCAAR*

Redfors

Dworeck

Angerås

et al. 2017

Cathet Cardio Intervent

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“…In patients with cardiac arrest, a comparable bolus volume was administered without clinically relevant pulmonary congestion 23. In addition, the rate of arrhythmic events is similar to existing data 24 25. There were no adverse events associated with the cooling procedure itself.…”

Section: Discussionsupporting

confidence: 60%

Strategic target temperature management in myocardial infarction—a feasibility trial

Testori

Sterz

Delle‐Karth

et al. 2013

Heart

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ObjectiveThe purpose of this study was to demonstrate the feasibility of a combined cooling strategy started out of hospital as an adjunctive to percutaneous coronary intervention (PCI) in the treatment of ST-elevation acute coronary syndrome (STE-ACS).DesignNon-randomised, single-centre feasibility trial.SettingDepartment of emergency medicine of a tertiary-care facility, Medical University of Vienna, Vienna, Austria. In cooperation with the Municipal ambulance service of the city of Vienna.PatientsConsecutive patients with STE-ACS presenting to the emergency medical service within 6 h after symptom onset.InterventionsCooling was initiated with surface cooling pads in the out-of-hospital setting, followed by the administration of 1000–2000 mL of cold saline at hospital arrival and completed by endovascular cooling in the catheterisation laboratory.Main outcome measuresFeasibility of lowering core temperature below 35.0°C prior to immediately performed revascularisation. Safety and tolerability of the cooling procedure.ResultsIn enrolled 19 patients (one woman, median age 51 years (IQR 45–59)), symptom onset to first medical contact (FMC) was 45 min (IQR 31–85). A core temperature below 35.0°C at reperfusion of the culprit lesion was achieved in 11 patients (78%) within 100 min (IQR 90–111) after FMC without any cooling-related serious adverse event. Temperature could be lowered from baseline 36.4°C (IQR 36.2–36.5°C) to 34.4°C (IQR 34.1–35.0°C) at the time of reperfusion.ConclusionsWith limitations an immediate out-of-hospital therapeutic hypothermia strategy was feasible and safe in patients with STE-ACS undergoing primary PCI.Clinical trial registrationhttp://www.clinicaltrials.gov/ct2/show/NCT01864343; clinical trials unique identifier: NCT01864343

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“…Several studies have assessed in-hospital, medium and long-term outcomes for PCI therapy during on-hours compared to off-hours. Distinct longer delay times during off-hours are found in most of these studies, but there are conflicting results in terms of angiographic and clinical outcomes for patients treated during off-hours (Beohar et al, 2001;Berger et al, 2006;Casella et al, 2011;Cubeddu et al, 2013;De Luca et al, 2005;Jneid et al, 2008;Noman et al, 2012;Ortolani et al, 2007;Sadeghi et al, 2004;Saleem et al, 2004;Uyarel et al, 2009;Zahn et al, 1999). These conflicting results may be due to presentation of sicker patients and less successful PCI procedures during off-hours (Glaser et al, 2008).…”

Section: Discussionmentioning

confidence: 83%

Time of symptom onset and value of myocardial blush and infarct size on prognosis in patients with ST-elevation myocardial infarction

Wieringa¹,

Lexis²,

Mahmoud³

et al. 2014

Chronobiology International

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In patients with ST-segment elevation myocardial infarction (STEMI), the time of onset of ischemia has been associated with myocardial infarction (MI) size. Myocardial blush grade (MBG) reflects myocardial response to ischemia/reperfusion injury, which may differ according to time of the day. The aim of our study was to explore the 24-hour variation in MBG and MI size in relation to outcomes in STEMI patients. A retrospective multicenter analysis of 6970 STEMI patients was performed. Time of onset of STEMI was divided into four 6-hour periods. STEMI patients have a significant 24-hour pattern in onset of symptoms, with peak onset around 09:00 hour. Ischemic time was longest and MI size, estimated by peak creatine kinase concentration, was largest in patients with STEMI onset between 00:00 and 06:00 hours. Both MBG and MI size were independently associated with mortality. Time of onset of STEMI was not independently associated with mortality when corrected for baseline and procedural factors. Interestingly, patients presenting with low MBG between 00:00 and 06:00 hours had a better prognosis compared to other groups. In conclusion, patients with symptom onset between 00:00 and 06:00 hours have longer ischemic time and consequently larger MI size. However, this does not translate into a higher mortality in this group. In addition, patients with failed reperfusion presenting in the early morning hours have better prognosis, suggesting a 24-hour pattern in myocardial protection.

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Outcome of Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention During On- Versus Off-hours (A Harmonizing Outcomes With RevasculariZatiON and Stents in Acute Myocardial Infarction [HORIZONS-AMI] Trial Substudy)

Cited by 35 publications

References 23 publications

Prognosis is similar for patients who undergo primary PCI during regular‐hours and off‐hours: A report from SCAAR*

Prognosis is similar for patients who undergo primary PCI during regular‐hours and off‐hours: A report from SCAAR*

Strategic target temperature management in myocardial infarction—a feasibility trial

Time of symptom onset and value of myocardial blush and infarct size on prognosis in patients with ST-elevation myocardial infarction

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