Chest Pain-to-Emergency Department Time Effect on EF After Primary PCI

Document Type : Original Article

Authors

1 Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IR Iran.

2 Cardiovascular Department, Hormozgan University of Medical Sciences Shahid Mohammadi Hospital, Bandar Abbas IR Iran.

3 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

Abstract

Background: For several years now, primary percutaneous coronary intervention (PPCI) has been considered an effective treatment for ST-elevation myocardial infarction (STEMI). Efforts have been made to reduce the time interval between the patient’s admission to the hospital and PPCI. We evaluated the effect of the time interval between patients’ admission to the emergency department and PPCI on left ventricular ejection fraction (LVEF) in patients with STEMI.
Methods: The target population comprised patients who were admitted to the Emergency Department of Shahid Mohammadi Hospital with acute STEMI and scheduled for PPCI between 2017 and 2018. Eventually, 174 patients, who met the inclusion criteria, were investigated using a questionnaire, and the data were analyzed by SPSS20.
Results: From the 174 patients diagnosed with acute STEMI, 72% were male and 28% were female. The mean age of the patients was 57.2 years (SD= ±13). A statistically significant linear relationship existed between symptom-to-balloon time and LVEF (P≤0.05), but no statistically significant linear relationship existed between the door-to-balloon time (DBT) and LVEF (P≤0.05).
Conclusions: Reducing symptom-to-balloon time in PPCI for patients with acute STEMI could preserve LVEF and improve prognosis. (Iranian Heart Journal 2022; 23(2): 68-74)

Keywords


  1. Weaver WD, Simes RJ, Betriu A, Grines CL, Zijlstra F, Garcia E, et al. Comparison of primary coronary angioplasty and intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review. Jama. 1997; 278(23):2093-8.
  2. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe 2014: epidemiological update. European heart journal. 2014; 35(42):2950-9.
  3. Keikha S. Electrocardiographic Results of Patients with Acute Coronary Syndrome. Iranian Journal of Emergency Medicine. 2015; 2(1):1.
  4. Park YH, Kang GH, Song BG, Chun WJ, Lee JH, Hwang SY, et al. Factors related to prehospital time delay in acute ST-segment elevation myocardial infarction. Journal of Korean medical science. 2012; 27(8):864-9.
  5. Lincoff AM. Managing acute coronary syndromes: decades of progress. Cleveland Clinic journal of medicine. 2014; 81(4):233-42.
  6. Knot J, Widimsky P, Wijns W, Stenestrand U, Kristensen SD, Van AH, et al. How to set up an effective national primary angioplasty network: lessons learned from five European countries. EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2009; 5(3):299, 301-9.
  7. Aversano T, Aversano LT, Passamani E, Knatterud GL, Terrin ML, Williams DO, et al. Thrombolytic therapy vs primary percutaneous coronary intervention for myocardial infarction in patients presenting to hospitals without on-site cardiac surgery: a randomized controlled trial. Jama. 2002; 287(15):1943-51.
  8. Berger PB, Ellis SG, Holmes Jr DR, Granger CB, Criger DA, Betriu A, et al. Relationship between delay in performing direct coronary angioplasty and early clinical outcome in patients with acute myocardial infarction: results from the global use of strategies to open occluded arteries in Acute Coronary Syndromes (GUSTO-IIb) trial. Circulation. 1999; 100(1):14-20.
  9. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Journal of the American College of Cardiology. 2004; 44(3):671-719.
  10. Dadu RT, El-Refai M, Davis A, Bobek J, Chiang I-H, Alam M, et al. IMPACT OF SHORTER DOOR TO BALLOON TIME ON LEFT VENTRICULAR EJECTION FRACTION IN STEMI PATIENTS WHO PRESENT EARLY TO HOSPITAL. Journal of the American College of Cardiology. 2016; 67(13 Supplement):657.
  11. Bates ER. Timeliness of treatment is more important than choice of reperfusion therapy. Cleveland Clinic journal of medicine. 2010; 77(9):567.
  12. Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF. Braunwald's Heart Disease E-Book: A Textbook of Cardiovascular Medicine: Elsevier Health Sciences; 2018.
  13. Aasa M, Henriksson M, Dellborg M, Grip L, Herlitz J, Levin LA, et al. Cost and health outcome of primary percutaneous coronary intervention versus thrombolysis in acute ST-segment elevation myocardial infarction-Results of the Swedish Early Decision reperfusion Study (SWEDES) trial. American heart journal. 2010; 160(2):322-8.
  14. Dholpuria R, Raja S, Gupta B, Chahar C, Panwar R, Gupta R, et al. Atherosclerotic risk factors in adolescents. The Indian Journal of Pediatrics. 2007; 74(9):823-6.
  15. Ting HH, Bradley EH, Wang Y, Nallamothu BK, Gersh BJ, Roger VL, et al. Delay in presentation and reperfusion therapy in ST-elevation myocardial infarction. The American journal of medicine. 2008; 121(4):316-23.
  16. Rahuman M, Jayawardana J, Francis G, Niraj M, Kumara A, Wijesinghe U, et al. Outcome of early coronary intervention for acute ST elevation myocardial infarction in a tertiary care cardiac centre in Sri Lanka. Ceylon Medical Journal. 2016; 61(1).
  17. Menees DS, Peterson ED, Wang Y, Curtis JP, Messenger JC, Rumsfeld JS, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. New England Journal of Medicine. 2013; 369(10):901-9
  18. Minutello RM, Kim L, Aggarwal S, Cuomo LJ, Feldman DN, Wong SC. Door-to-balloon time in primary percutaneous coronary intervention predicts degree of myocardial necrosis as measured using cardiac biomarkers. Texas Heart Institute Journal. 2010; 37(2):161.
  19. Rezaey K, Kohestany H, Baghcheghy N, Yazdan Khah Fard M. Evaluation of the time Interval between the onset of symptoms to hospitalization in acute myocardial infarction cases admitted. Bushehr port in. 2006; 1384:67-75.
  20. Farshidi H, Rahimi S, Abdi A, Salehi S, Madani A. Factors associated with pre-hospital delay in patients with acute myocardial infarction. Iranian Red Crescent Medical Journal. 2013 Apr; 15(4):312.
  21. Duration of chest pain to hospitalization in cardiac center, in acute myocardial infarction cases admitted, in Rasht, in 1384. Iranian Journal of Forensic Medicine. 2008; 13(4):228-34.