Impact of time-to-treatment on myocardial perfusion after primary percutaneous coronary intervention with Gp IIb-IIIa inhibitors
Impact of time-to-treatment on myocardial perfusion after primary percutaneous coronary intervention with Gp IIb-IIIa inhibitors
复制标题
DOI：
10.2459/jcm.0b013e32835fcb38
复制
发表时间：
2013-11-01
影响因子：
3
通讯作者：
Bellandi, Francesco
中科院分区：
文献类型：
--
作者：
De Luca, Giuseppe;Gibson, Michael C.;Bellandi, Francesco
背景原发性血管成形术已被证明是上级溶栓。然而，先前的报告显示，即使采用机械再灌注，较长的治疗时间对心肌灌注和存活率也有负面影响。然而，这些有害的影响可能会克服广泛使用的糖蛋白（GP）IIb-IIIa抑制剂。因此，目前的研究的目的是评估的预后作用的间隔从症状发作到再灌注在一个大型队列的患者接受主血管成形术与GP IIb-IIIa inhibitors.MethodsOur人口是由1560例患者接受主血管成形术ST段抬高心肌梗死（STEMI）包括在EGYPT（早期糖蛋白IIb-IIIa抑制剂在主血管造影）数据库。心肌灌注通过血管造影或ST段回落来评估，而梗死面积则通过肌酸激酶峰值和肌酸激酶同工酶（CK-MB）来评估。随访数据收集30天和1年后，主要angioplasty. ResultsTime治疗显着相关的年龄和女性性别，糖尿病和以前的心肌梗死（MI），但呈负相关的吸烟。治疗时间影响心肌梗死术后溶栓率（TIMI）3血流（P
BackgroundPrimary angioplasty has been shown to be superior to thrombolysis. However, previous reports have shown a negative impact of longer time-to-treatment on myocardial perfusion and survival even with mechanical reperfusion. However, these deleterious effects might potentially be overcome by an extensive use of glycoprotein (Gp) IIb-IIIa inhibitors. Thus, the aim of the current study was to evaluate the prognostic role of the interval from symptoms onset to reperfusion in a large cohort of patients undergoing primary angioplasty with Gp IIb-IIIa inhibitors.MethodsOur population is represented by 1560 patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI) included in the EGYPT (Early Glycoprotein IIb-IIIa Inhibitors in Primary Angiography) database. Myocardial perfusion was evaluated by angiography or ST-segment resolution, whereas infarct size was estimated by using peak creatine kinase and creatine kinase-MB (CK-MB). Follow-up data were collected between 30 days and 1 year after primary angioplasty.ResultsTime-to-treatment was significantly associated with age and female sex, diabetes and previous myocardial infarction (MI), but inversely related to smoking. Time-to-treatment affected the rate of postprocedural thrombolysis in myocardial infarction (TIMI) 3 flow (P