Effect of Ischemia Duration and Door-to-Balloon Time on Myocardial Perfusion in ST-Segment Elevation Myocardial Infarction An 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, Gregg W. Stone

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Objectives This study sought to investigate the effect of treatment delay on microvascular reperfusion in ST-segment elevation myocardial infarction (STEMI) patients from the large, multicenter, prospective HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial. Background Despite restoration of epicardial blood flow during primary percutaneous coronary intervention (PCI), one-third of patients do not obtain myocardial perfusion due to impairment in the microvascular circulation. Methods We examined the effect of symptom onset-to-balloon time (SBT) and door-to-balloon time (DBT) on myocardial reperfusion during primary PCI in STEMI, utilizing resolution of ST-segment elevation (STR) and the myocardial blush grade (MBG). The primary analysis was the relationships between SBT >2, >2 to 4, and >4 h and DBT >1, >1 to 1.5, >1.5 to 2, and >2 h with MBG and STR. Clinical risk was assessed using a modified version of the Thrombolysis In Myocardial Infarction risk score for STEMI. Results In 2,056 patients, absent microvascular perfusion (MBG 0/1) and STR (STR

Original languageEnglish (US)
Pages (from-to)1966-1974
Number of pages9
JournalJACC: Cardiovascular Interventions
Volume8
Issue number15
DOIs
StatePublished - Dec 28 2015

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Keywords

  • ischemia duration
  • myocardial infarction
  • PCI
  • perfusion
  • STEMI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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