Reperfusion times and in-hospital outcomes among patients with an isolated posterior myocardial infarction: Insights from the National Cardiovascular Data Registry (NCDR) - 26/02/14
, Daniel A. Brenner, MD, PhD b, Shuang Li, MS c, Karen Alexander, MD c, Peter Ganz, MD d, eRiassunto |
Background |
A posterior myocardial infarction (PMI) is associated with significant morbidity and delays in recognition may prevent the timely revascularization of these patients. The present study sought to evaluate the reperfusion times and in-hospital outcomes among patients with an isolated PMI.
Methods |
Clinical characteristics and reperfusion times were compared between those with an isolated PMI and those with all other ST-elevation myocardial infarctions (STEMI) in the NCDR ACTION-GWTG Registry from 2007 to 2012. Logistic generalized estimating equations were used to examine risk-adjusted mortality.
Results |
Among 117,739 subjects with a STEMI, 824 (0.7%) had evidence of an isolated PMI. The median time between patient arrival and initial electrocardiogram was similar between those with an isolated PMI and those with a non-PMI STEMI (6 vs. 6 minutes, P = .48). However, the median time from initial electrocardiogram to percutaneous coronary intervention was significantly longer among subjects with a PMI (69 vs 61 minutes, P < .01) and fewer patients achieved a door-to-balloon time less than 90 minutes (83% vs 89%, P < .01). After multivariable adjustment, in-hospital mortality was similar for PMI patients compared to those with a non-PMI STEMI (AOR: 1.11, 95% CI: 0.83–1.50).
Conclusion |
The door-to-balloon times are significantly longer for those with an isolated PMI resulting in fewer patients receiving reperfusion within the guideline recommended time period. Ongoing educational initiatives to increase recognition of a PMI are needed to improve the reperfusion times and outcomes associated with this condition.
Il testo completo di questo articolo è disponibile in PDF.Mappa
| Micheal P. Hudson, MD, served as guest editor for this article. |
Vol 167 - N° 3
P. 350-354 - Marzo 2014 Ritorno al numero
Articolo precedente
- Rationale and design of the familial hypercholesterolemia foundation CAscade SCreening for Awareness and DEtection of Familial Hypercholesterolemia registry
- Emily C. O’Brien, Matthew T. Roe, Elizabeth S. Fraulo, Eric D. Peterson, Christie M. Ballantyne, Jacques Genest, Samuel S. Gidding, Emma Hammond, Linda C. Hemphill, Lisa C. Hudgins, Iris Kindt, Patrick M. Moriarty, Joyce Ross, James A. Underberg, Karol Watson, Dave Pickhardt, Daniel J. Rader, Katherine Wilemon, Joshua W. Knowles
- Hospital patterns of medical management strategy use for patients with non–ST-elevation myocardial infarction and 3-vessel or left main coronary artery disease
- Ralf E. Harskamp, Tracy Y. Wang, Deepak L. Bhatt, Stephen D. Wiviott, Ezra A. Amsterdam, Shuang Li, Laine Thomas, Robbert J. de Winter, Matthew T. Roe
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?