Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction
Importance of time to reperfusion for 30-day and late survival and recovery of left ventricular function after primary angioplasty for acute myocardial infarction
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DOI：
10.1016/s0735-1097(98)00395-7
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发表时间：
1998-11-01
影响因子：
24
通讯作者：
Kelly, TA
中科院分区：
文献类型：
--
作者：
Brodie, BR;Stuckey, TD;Kelly, TA
目标。本研究的目的是评估急性心肌梗死初级血管成形术后再灌注时间对预后的重要性。急性心肌梗死溶栓治疗的生存获益与治疗时间密切相关。最近的观察表明，治疗时间对原发性血管成形术患者的生存可能不太重要。经初级血管成形术治疗的急性心肌梗死患者（n = 1,352）连续随访13年。对606例心导管患者的急性期和随访期射血分数进行了对比分析。164例（12%）患者在2小时内实现再灌注，早期再灌注30天死亡率最低（6小时4.3%）。早期再灌注的30天以上晚期心脏死亡率也最低（6小时时为9.1%）。早期再灌注组左室射血分数改善最大，2 h后相对温和（6.9%）
Objectives. The purpose of this study was to evaluate the importance of time to reperfusion for outcomes after primary angioplasty for acute myocardial infarction.Background. Survival benefit of thrombolytic therapy for acute myocardial infarction is strongly dependent on time to treatment. Recent observations suggest that time to treatment may be less important for survival with primary angioplasty.Methods. Consecutive patients (n = 1,352) with acute myocardial infarction treated with primary angioplasty were followed for up to 13 years. Paired acute and follow-up ejection fraction data were obtained at cardiac catheterization in 606 patients.Results. Reperfusion was achieved within 2 h in 164 patients (12%), Thirty day mortality was lowest with early reperfusion (4.3% at 6 h). Thirty-day-plus late cardiac mortality was also lowest with early reperfusion (9.1% at 6 h). Improvement in left ventricular ejection fraction was greatest in the early reperfusion group and relatively modest after 2 h (6.9% at