on August 18, 2003
Circulation. 2003
Published online before print August 18, 2003, doi: 10.1161/01.CIR.0000086346.32856.9C
Published online before print August 18, 2003, doi: 10.1161/01.CIR.0000086346.32856.9C
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on May 7, 2003
From Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar (A.S., G.N., J.M., H.S., J.P., S.M., H.B., A.K.), Klinik und Poliklinik für Nuklearmedizin rechts der Isar (M.S., S.N.), Technische Universität Munich, Germany. * To whom correspondence should be addressed. E-mail: aschoemig{at}dhm.mhn.de.
Background--The relationship between myocardial salvage and time-to-treatment interval in patients with acute myocardial infarction (AMI) treated with coronary artery stenting or thrombolysis has not been studied. Methods and Results--This study analyzed 264 patients with AMI randomized to coronary stenting (133 patients) or thrombolysis (131 patients) in the setting of 2 randomized trials. Patients were divided into the following 3 groups defined by tertiles of the time-to-treatment interval: lower tertile (<165 minutes), middle tertile (165 to 280 minutes), and upper tertile (>280 minutes). Paired scintigraphic examinations were performed to obtain salvage index, which was the primary end point of the study. In the group with thrombolysis, the salvage index (median [25th; 75th] percentile) was 0.45 (0.16; 0.83) in the lower, 0.29 (0.17; 0.48) in the middle, and 0.20 (0.04; 0.46) in the upper tertile (P=0.03). In the group with stenting, the salvage index was 0.56 (0.49; 0.75) in the lower, 0.57 (0.36; 0.73) in the middle, and 0.57 (0.32; 0.75) in the upper tertile (P=0.59). In patients treated with stenting, the salvage index was greater than in patients treated with thrombolysis in the lower (0.56 versus 0.45, P=0.09), middle (0.57 versus 0.29, P=0.0003), and upper (0.57 versus 0.20, P=0.0005) tertiles of the time-to-treatment interval. Conclusions--The influence of the time-to-treatment interval on the myocardial salvage in patients with AMI depends on the type of reperfusion therapy. Coronary artery stenting was superior to thrombolysis independent of the time-to-treatment intervals, and the difference in benefit increased with more prolonged time from symptom onset.
Revised on June 12, 2003
Accepted on June 13, 2003
Therapy-Dependent Influence of Time-to-Treatment Interval on Myocardial Salvage in Patients With Acute Myocardial Infarction Treated With Coronary Artery Stenting or Thrombolysis
Albert Schömig MD*,
Key words: myocardial infarction • stents • thrombolysis • scintigraphy
This article has been cited by other articles:
 |
|
 |
|
  M. Francone, C. Bucciarelli-Ducci, I. Carbone, E. Canali, R. Scardala, F. A. Calabrese, G. Sardella, M. Mancone, C. Catalano, F. Fedele, et al. Impact of Primary Coronary Angioplasty Delay on Myocardial Salvage, Infarct Size, and Microvascular Damage in Patients With ST-Segment Elevation Myocardial Infarction Insight From Cardiovascular Magnetic Resonance. J. Am. Coll. Cardiol., December 1, 2009; 54(23): 2145 - 2153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Ndrepepa, A. Schomig, and A. Kastrati The Only Better Alternative to Rescue Percutaneous Coronary Intervention Is Primary Percutaneous Coronary Intervention. J. Am. Coll. Cardiol., July 7, 2009; 54(2): 127 - 129. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Busk, A. Kaltoft, S. S. Nielsen, M. Bottcher, M. Rehling, L. Thuesen, H. E. Botker, J. F. Lassen, E. H. Christiansen, L. R. Krusell, et al. Infarct size and myocardial salvage after primary angioplasty in patients presenting with symptoms for <12 h vs. 12-72 h Eur. Heart J., June 1, 2009; 30(11): 1322 - 1330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S Rathore, J. P Curtis, J. Chen, Y. Wang, B. K Nallamothu, A. J Epstein, H. M Krumholz, and for the National Cardiovascular Data Registry Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study BMJ, May 19, 2009; 338(may19_1): b1807 - b1807. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. W. Armstrong, C. M. Westerhout, and R. C. Welsh Duration of Symptoms Is the Key Modulator of the Choice of Reperfusion for ST-Elevation Myocardial Infarction Circulation, March 10, 2009; 119(9): 1293 - 1303. [Full Text] [PDF]
|
|
|
|
|
|
P. Bogaty Duration of Symptoms Is Not Always the Key Modulator of the Choice of Reperfusion for ST-Elevation Myocardial Infarction Circulation, March 10, 2009; 119(9): 1304 - 1310. [Full Text] [PDF]
|
|
|
|
|
|
M. C.A. Kramer, A. C. van der Wal, K. T. Koch, J. P.H.M. Ploegmakers, R. J. van der Schaaf, J. P.S. Henriques, J. Baan Jr, S. Z.H. Rittersma, M. M. Vis, J. J. Piek, et al. Presence of Older Thrombus Is an Independent Predictor of Long-Term Mortality in Patients With ST-Elevation Myocardial Infarction Treated With Thrombus Aspiration During Primary Percutaneous Coronary Intervention Circulation, October 28, 2008; 118(18): 1810 - 1816. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. W. Stone Angioplasty Strategies in ST-Segment-Elevation Myocardial Infarction: Part I: Primary Percutaneous Coronary Intervention Circulation, July 29, 2008; 118(5): 538 - 551. [Full Text] [PDF]
|
|
|
|
|
|
E. R. Bates and B. K. Nallamothu Commentary: The Role of Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction Circulation, July 29, 2008; 118(5): 567 - 573. [Full Text] [PDF]
|
|
|
|
 |
|
 S. G. Ellis, M. Tendera, M. A. de Belder, A. J. van Boven, P. Widimsky, L. Janssens, H.R. Andersen, A. Betriu, S. Savonitto, J. Adamus, et al. Facilitated PCI in Patients with ST-Elevation Myocardial Infarction N. Engl. J. Med., May 22, 2008; 358(21): 2205 - 2217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B Nallamothu, K A A Fox, B M Kennelly, F Van de Werf, J M Gore, P G Steg, C B Granger, O H Dabbous, E Kline-Rogers, K A Eagle, et al. Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events Heart, December 1, 2007; 93(12): 1552 - 1555. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Carstensen, G. C.I. Nelson, P. S. Hansen, L. Macken, S. Irons, M. Flynn, P. Kovoor, S. Y. Soo Hoo, M. R. Ward, and H. H. Rasmussen Field triage to primary angioplasty combined with emergency department bypass reduces treatment delays and is associated with improved outcome Eur. Heart J., October 1, 2007; 28(19): 2313 - 2319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. J. Kiernan, H. H. Ting, and B. J. Gersh Facilitated percutaneous coronary intervention: current concepts, promises, and pitfalls Eur. Heart J., July 1, 2007; 28(13): 1545 - 1553. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Thiele, M. J. Kappl, A. Linke, S. Erbs, E. Boudriot, A. Lembcke, D. Kivelitz, and G. Schuler Influence of time-to-treatment, TIMI-flow grades, and ST-segment resolution on infarct size and infarct transmurality as assessed by delayed enhancement magnetic resonance imaging Eur. Heart J., June 6, 2007; (2007) ehm173v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Stenestrand, J. Lindback, L. Wallentin, and for the RIKS-HIA Registry Long-term outcome of primary percutaneous coronary intervention vs prehospital and in-hospital thrombolysis for patients with ST-elevation myocardial infarction. JAMA, October 11, 2006; 296(14): 1749 - 1756. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, G. Ndrepepa, and A. Kastrati Late myocardial salvage: time to recognize its reality in the reperfusion therapy of acute myocardial infarction Eur. Heart J., August 2, 2006; 27(16): 1900 - 1907. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kaltoft, M. Bottcher, S. S. Nielsen, H.-H. T. Hansen, C. Terkelsen, M. Maeng, J. Kristensen, L. Thuesen, L. R. Krusell, S. D. Kristensen, et al. Routine Thrombectomy in Percutaneous Coronary Intervention for Acute ST-Segment-Elevation Myocardial Infarction: A Randomized, Controlled Trial Circulation, July 4, 2006; 114(1): 40 - 47. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. McNamara, Y. Wang, J. Herrin, J. P. Curtis, E. H. Bradley, D. J. Magid, E. D. Peterson, M. Blaney, P. D. Frederick, H. M. Krumholz, et al. Effect of Door-to-Balloon Time on Mortality in Patients With ST-Segment Elevation Myocardial Infarction J. Am. Coll. Cardiol., June 6, 2006; 47(11): 2180 - 2186. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Parodi, G Memisha, R Valenti, M Trapani, A Migliorini, G M Santoro, and D Antoniucci Five year outcome after primary coronary intervention for acute ST elevation myocardial infarction: results from a single centre experience Heart, December 1, 2005; 91(12): 1541 - 1544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. P. Wharton Jr, E. C. Keeley, C. L. Grines, T. P. Wharton Jr, E. C. Keeley, and C. L. Grines The Case for Community Hospital Angioplasty Circulation, November 29, 2005; 112(22): 3509 - 3534. [Full Text] [PDF]
|
|
|
|
|
|
K. Huber, R. D. Caterina, S. D. Kristensen, F. W.A. Verheugt, G. Montalescot, L. B. Maestro, F. V. d. Werf, and for the Task Force on Pre-hospital Reperfusion The Pre-hospital reperfusion therapy: a strategy to improve therapeutic outcome in patients with ST-elevation myocardial infarction Eur. Heart J., October 1, 2005; 26(19): 2063 - 2074. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Elsasser and C. W. Hamm Percutaneous coronary intervention guidelines: new aspects for the interventional treatment of acute coronary syndromes Eur. Heart J. Suppl., October 1, 2005; 7(suppl_K): K5 - K9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gick, N. Jander, H.-P. Bestehorn, R.-P. Kienzle, M. Ferenc, K. Werner, T. Comberg, K. Peitz, D. Zohlnhofer, V. Bassignana, et al. Randomized Evaluation of the Effects of Filter-Based Distal Protection on Myocardial Perfusion and Infarct Size After Primary Percutaneous Catheter Intervention in Myocardial Infarction With and Without ST-Segment Elevation Circulation, September 6, 2005; 112(10): 1462 - 1469. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Zahn, A Vogt, U Zeymer, A K Gitt, K Seidl, M Gottwik, M A Weber, W Niederer, B Modl, H-J Engel, et al. In-hospital time to treatment of patients with acute ST elevation myocardial infarction treated with primary angioplasty: determinants and outcome. Results from the registry of percutaneous coronary interventions in acute myocardial infarction of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausarzte Heart, August 1, 2005; 91(8): 1041 - 1046. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schomig, J. Mehilli, D. Antoniucci, G. Ndrepepa, C. Markwardt, F. Di Pede, S. G. Nekolla, K. Schlotterbeck, H. Schuhlen, J. Pache, et al. Mechanical Reperfusion in Patients With Acute Myocardial Infarction Presenting More Than 12 Hours From Symptom Onset: A Randomized Controlled Trial JAMA, June 15, 2005; 293(23): 2865 - 2872. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, S. Silber, P. Albertsson, F. F. Aviles, P. G. Camici, A. Colombo, C. Hamm, E. Jorgensen, J. Marco, J.-E. Nordrehaug, et al. Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology Eur. Heart J., April 2, 2005; 26(8): 804 - 847. [Full Text] [PDF]
|
|
|
|
|
|
G. W. Stone, J. Webb, D. A. Cox, B. R. Brodie, M. Qureshi, A. Kalynych, M. Turco, H. P. Schultheiss, D. Dulas, B. D. Rutherford, et al. Distal Microcirculatory Protection During Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction: A Randomized Controlled Trial JAMA, March 2, 2005; 293(9): 1063 - 1072. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. J. Gersh, G. W. Stone, H. D. White, and D. R. Holmes Jr Pharmacological Facilitation of Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: Is the Slope of the Curve the Shape of the Future? JAMA, February 23, 2005; 293(8): 979 - 986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. P de Jaegere, P. W Serruys, and M. L Simoons Should all patients with an acute myocardial infarction be referred for direct PTCA? Heart, November 1, 2004; 90(11): 1352 - 1357. [Full Text] [PDF]
|
|
|
|
|
|
C. M. Gibson, S. A. Murphy, A. J. Kirtane, R. P. Giugliano, C. P. Cannon, E. M. Antman, E. Braunwald, and TIMI Study Group Association of duration of symptoms at presentation with angiographic and clinical outcomes after fibrinolytic therapy in patients with st-segment elevation myocardial infarction J. Am. Coll. Cardiol., September 1, 2004; 44(5): 980 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. C. Keeley and C. L. Grines Primary Percutaneous Coronary Intervention for Every Patient with ST-Segment Elevation Myocardial Infarction: What Stands in the Way? Ann Intern Med, August 17, 2004; 141(4): 298 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. De Luca, A. W.J van't Hof, M.-J. de Boer, J. P. Ottervanger, J. C.A Hoorntje, A.T.M. Gosselink, J.-H. E Dambrink, F. Zijlstra, and H. Suryapranata Time-to-treatment significantly affects the extent of ST-segment resolution and myocardial blush in patients with acute myocardial infarction treated by primary angioplasty Eur. Heart J., June 2, 2004; 25(12): 1009 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Ndrepepa, J. Mehilli, M. Schwaiger, H. Schuhlen, S. Nekolla, S. Martinoff, C. Schmitt, J. Dirschinger, A. Schomig, and A. Kastrati Prognostic Value of Myocardial Salvage Achieved by Reperfusion Therapy in Patients with Acute Myocardial Infarction J. Nucl. Med., May 1, 2004; 45(5): 725 - 729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Leoncini, F. Bellandi, R. Sciagra, M. Maioli, A. Toso, A. Coppola, S. Sestini, A. Mennuti, R. P. Dabizzi, and A. Pupi Gated SPECT Evaluation of the Relationship Between Admission Troponin I, Myocardial Salvage, and Functional Recovery in Acute Myocardial Infarction Treated by Abciximab and Early Primary Angioplasty J. Nucl. Med., May 1, 2004; 45(5): 739 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. O. Williams Treatment Delayed Is Treatment Denied Circulation, April 20, 2004; 109(15): 1806 - 1808. [Full Text] [PDF]
|
|
|
|
|
|
W. W. O'Neill and S. R. Dixon The year in interventional cardiology J. Am. Coll. Cardiol., March 3, 2004; 43(5): 875 - 890. [Full Text] [PDF]
|
|
|
|
|
|
P. Elsman, F. W.A. Verheugt, E. J.P. Lamfers, A. Schomig, G. Ndrepepa, J. Mehilli, M. Schwaiger, H. Schuhlen, S. Nekolla, J. Pache, et al. Influence of Time to Treatment Interval on Myocardial Salvage in Patients With Acute Myocardial Infarction Treated With Coronary Artery Stenting or Thrombolysis * Response Circulation, February 24, 2004; 109 (7): e68 - e68. [Full Text] [PDF]
|
|
|
|
|
|
R. P. Giugliano and E. Braunwald Selecting the Best Reperfusion Strategy in ST-Elevation Myocardial Infarction: It's All a Matter of Time Circulation, December 9, 2003; 108(23): 2828 - 2830. [Full Text] [PDF]
|
|