Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Impact of diagnostic ECG to wire delay in STEMI patients treated with primary PCI - a DANAMI-3 substudy

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Fractional Flow Reserve Guided PCI in Patients With and Without Left Ventricular Hypertrophy: a DANAMI-3-PRIMULTI Sub-study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. A novel supra-annular plane to predict TAVI prosthesis anchoring in raphe-type bicuspid aortic valve disease: the LIRA plane

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Myocardial damage after ST-segment elevation myocardial infarction by use of bivalirudin or heparin: a DANAMI-3 substudy

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Switching from Vitamin K Antagonist to Dabigatran in Atrial Fibrillation: Differences According to Dose

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Vitamin K antagonists vs. direct oral anticoagulants after transcatheter aortic valve implantation in atrial fibrillation

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Pulmonary Arterial Enlargement in Well-Treated Persons With Human Immunodeficiency Virus

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Left ventricular myocardial crypts: morphological patterns and prognostic implications

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Left ventricular trabeculation and major adverse cardiovascular events: the Copenhagen General Population Study

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS: We evaluated the impact of delay from diagnostic pre-hospital electrocardiogram (ECG) to wiring of the infarct related vessel (ECG-to-wire) >120 minutes on cardiovascular magnetic resonance (CMR) markers of reperfusion success and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI).

METHODS AND RESULTS: We included 1492 patients in the analyses of clinical outcome. CMR was performed in 748 patients to evaluate infarct size and myocardial salvage. In total, 304 patients (20%) had ECG-to-wire >120 minutes, which was associated with larger acute infarct size (18% [interquartile range (IQR), 10-28] vs. 15% [8-24]; p=0.022) and smaller myocardial salvage (0.42 [IQR 0.28-0.57] vs. 0.50 [IQR 0.34-0.70]; p=0.002). However, 33% of the patients with ECG-to-wire >120 minutes still had a substantial myocardial salvage of more than 0.50. In a multivariable analysis ECG-to-wire >120 minutes was associated with an increased risk of all-cause mortality and heart failure (hazard ratio 1.61 [95% confidence interval 1.14-2.26], p=0.007).

CONCLUSIONS: ECG-to-wire > 120 minutes was associated with larger infarct size, smaller myocardial salvage and a poorer clinical outcome in STEMI patients transferred for primary percutaneous coronary intervention. However, myocardial salvage was still substantial in one third of patients treated beyond 120 minutes of delay.

Original languageEnglish
JournalEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Volume14
Issue number6
Pages (from-to)700-707
ISSN1774-024X
DOIs
Publication statusPublished - 2018

    Research areas

  • Journal Article

ID: 52618060