Reperfusion Delay and its Main Correlates in Patients with ST-Segment Elevation Myocardial Infarction under Primary PCI

Abstract

Background: Various strategies have been proposed to minimize reperfusion delay in patients who are candidate for primary percutaneous coronary intervention (PCI). Reperfusion time may be affected by both intra- and extra-hospital factors. The study attempted to identify factors affecting reperfusion time to reduce mortality and morbidity. Materials and Methods: In this cross-sectional study, 95 patients with chest pain who were admitted to a hospital emergency in Tehran (capital city of Iran) were admitted and those who were diagnosed with ST-segment elevation myocardial infarction (STEMI) were candidates for primary PCI. Basic information was asked from the patients or companion of them. In addition, the PCI time recorded in the patient file was entered in the checklist. Results: The mean interval between the onset of symptoms and primary PCI was 218.6±21.69 min. The interval between the first medical contact (FMC) and primary PCI was determined to be 87.122±183.66 minutes. The mean time of door to balloon in the hospital was 42.49±78.53 min. In addition, the mean time interval from symptom onset to FMC was 19.47±11.84 minutes. In 31 cases (32.6%), the emergency service (EMS) contacted. Three factors were identified to be associated with a delay between the onset of symptoms to primary PCI (or delay reperfusion time) including the previous history of myocardial infarction (MI) (p=0.034), the severity of coronary artery disease, based on angiography (p=0.043) and the type of vehicle used to transfer the patient to the hospital (p=0.007). Conclusion: The reperfusion delay seems to be higher in our treatment center than in other centers. Three preceding factors of MI, the severity of coronary artery disease and the transmission of patients via EMS are considered factors associated with the reduction of reperfusion delay.