0113: Factors associated with infarct-related artery patency before primary percutaneous coronary intervention for ST-elevation myocardial infarction: results from the FAST-MI 2010 registry

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• 作者：Clothilde Bailleul⁽¹⁾ ; Simon Tabassome⁽²⁾ ; Gregory Ducrocq⁽³⁾ ; Pierre Coste⁽⁴⁾ ; Didier Blanchard⁽¹⁾ ; Camille Brasselet⁽⁵⁾ ; Meyer Elbaz⁽⁷⁾ ; Gabriel Steg⁽⁶⁾ ; Francois Schiele⁽⁷⁾ ; Nicolas Danchin⁽⁷⁾ ; Etienne Puymirat ; ⁽⁷⁾ ; ^{etiennepuymirat@yahoo.fr" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：21
• 全文大小：52 K

文摘

Early infarct-related artery (IRA) patency is associated with better clinical outcomes in STEMI patients. Using the FAST-MI 2010 ST-elevation myocardial infarction (STEMI) cohort, we investigated factors related to IRA patency (TIMI 2/3 flow) at the start of procedure in patients admitted for primary percutaneous coronary intervention (PCI).

Methods and results

FAST-MI 2010 is a nationwide French registry including 4,169 Acute MI patients. Of 1452 STEMI patients with primary PCI, 466 (32%) had TIMI 2/3 flow of IRA before the procedure. Mean age (62±14 years in both groups), GRACE score (141±31 vs 142±34) and time from onset to angiography (472±499 vs 451±479min) did not differ according to IRA patency (TIMI2/3 vs TIMI 0/1). Using multivariate logistic regression analysis, IRA patency was more frequently found in patients having called earlier (<75min, median time from symptom onset: OR: 1.60; 95% CI 1.26-2.04), or receiving antiplatelet therapy (APT) before angiography. Increasing time from diagnostic ECG to angiography was also associated with IRA patency (>90min, OR: 1,38; 95%IC 1.08-1.77). The results were confirmed by propensity score analyses.

Conclusion

Pre-procedural IRA patency is observed in one third of STEMI patients; it is more frequently found in patients having received APT prior to angiography, as well as in patients having called early. Higher IRA patency with increasing time delays from qualifying ECG to angiography suggests an additional role of spontaneous or medication-mediated fibrinolysis.