JACC: Cardiovascular Interventions
Effect of Ischemia Duration and Door-to-Balloon Time on Myocardial Perfusion in ST-Segment Elevation Myocardial InfarctionAn Analysis From HORIZONS-AMI Trial (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction)
Abhiram Prasad, Bernard J. Gersh, Roxana Mehran, Bruce R. Brodie, Sorin J. Brener, José M. Dizon, Alexandra J. Lansky, Bernhard Witzenbichler, Ran Kornowski, Giulio Guagliumi, Dariusz Dudek and Gregg W. Stone
Table 1
Table 1
Baseline Characteristics According to Symptom Onset-to-Balloon Time
SBT ≤2 h (n = 162) | SBT >2 to 4 h (n = 976) | SBT >4 h (n = 918) | Combined (n = 2,056) | p Value All Groups | |
---|---|---|---|---|---|
Age, yrs | 54.1 (49.1–62.4) | 58.3 (50.7–68.3) | 61.4 (53.4–80.0) | 59.2 (51.8–69.2) | <0.0001 |
Men | 85.2 (138/162) | 77.0 (752/976) | 74.8 (687/918) | 76.7 (1,577/2,056) | 0.02 |
Body mass index, kg/m2 | 27.13 (24.79–30.86) | 27.13 (24.61–30.10) | 27.00 (24.45–30.25) | 27.06 (24.54–30.25) | 0.75 |
Hypertension | 51.2 (83/162) | 49.1 (479/976) | 53.5 (491/918) | 51.2 (1,053/2,056) | 0.16 |
Hyperlipidemia | 46.9 (76/162) | 43.3 (423/976) | 41.5 (381/918) | 42.8 (880/2,056) | 0.39 |
Smoking | 66.7 (108/162) | 65.9 (641/973) | 64.0 (584/912) | 65.1 (1,333/2,047) | 0.64 |
Diabetes mellitus | 9.9 (16/162) | 14.4 (141/976) | 18.5 (170/918) | 15.9 (327/2,056) | 0.005 |
Prior myocardial infarction | 9.3 (15/162) | 10.2 (100/976) | 10.5 (96/918) | 10.3 (211/2,056) | 0.90 |
Prior PCI | 11.7 (19/162) | 12.0 (117/976) | 8.4 (77/917) | 10.4 (213/2,055) | 0.03 |
Prior coronary artery bypass graft surgery | 0.6 (1/162) | 2.4 (23/976) | 2.8 (26/918) | 2.4 (50/2,056) | 0.24 |
Prior angina | 11.7 (19/162) | 17.8 (174/976) | 27.5 (252/917) | 21.7 (445/2,055) | <0.0001 |
History of congestive heart failure | 1.9 (3/162) | 2.2 (21/976) | 2.8 (26/918) | 2.4 (50/2,056) | 0.56 |
Killip class 1 | 95.1 (154/162) | 91.1 (888/975) | 90.3 (828/917) | 91.0 (1,870/2,054) | 0.15 |
Peripheral vascular disease | 0.6 (1/162) | 3.8 (37/975) | 4.7 (43/918) | 3.9 (81/2,055) | 0.05 |
History of renal insufficiency | 1.2 (2/162) | 3.2 (31/975) | 3.2 (29/918) | 3.0 (62/2,055) | 0.38 |
PCI to left anterior descending artery | 41.0 (71/173) | 42.4 (446/1,052) | 41.2 (412/1,000) | 41.8 (929/2,225) | 0.84 |
Pre-PCI TIMI 3 flow | 13.9 (24/173) | 18.6 (196/1,051) | 20.2 (202/999) | 19.0 (422/2,223) | 0.13 |
Post-PCI TIMI 3 flow | 97.1 (168/173) | 95.1 (1,000/1,052) | 88.9 (889/1,000) | 92.4 (2,057/2,225) | <0.0001 |
Clopidogrel administration | 100.0 (162/162) | 99.9 (975/976) | 99.6 (914/918) | 99.8 (2,051/2,056) | 0.27 |
Glycoprotein IIb/IIIa inhibitor use | 59.9 (97/162) | 53.6 (523/976) | 55.7 (510/915) | 55.0 (1,130/2,053) | 0.28 |
Drug-eluting stent | 70.4 (112/159) | 73.2 (687/939) | 70.5 (606/859) | 71.8 (1,405/1,957) | 0.43 |
Bare-metal stent | 30.8 (49/159) | 28.0 (263/939) | 30.7 (264/859) | 29.4 (576/1,957) | 0.41 |
Door-to-balloon time, min | 58 (47–73) | 93 (71–115) | 120 (87–172) | 98.00 (72–133) | <0.0001 |
Procedural success∗ | 90.8 (178/196) | 90.3 (1,072/1,187) | 82.7 (918/1,110) | 87.0 (2,168/2,493) | <0.0001 |
Left ventricular ejection fraction, % | 50.00 (45.00–55.00) | 50.00 (45.00–59.00) | 50.00 (40.00–58.00) | 50.00 (43.00–58.00) | 0.23 |
Values are median (interquartile range) or % (n/N).
PCI = percutaneous coronary intervention; SBT = symptom onset-to-balloon time; TIMI = Thrombolysis In Myocardial Infarction.
↵∗ TIMI flow grade 3 plus residual stenosis <50%.
Advertisement