A teljes ischaemiás idő prognosztikus jelentősége az ST-elevációval járó szívinfarktus
miatt kezelt betegekben [Prognostic significance of the total ischemic time in patients
with ST-elevation myocardial infarction]
Introduction: The significance of the total ischemic time (from the beginning of the
complaint to the opening of the vessel) is an important factor for myocardial salvage.
Aim: The aim of the study was to determine the prognostic significance of the TIT
in patients with ST elevation myocardial infarction in Hungary. Method: From 1 January
2014 all patients with myocardial infarction were recorded by law in an on-line database
of the Hungarian Myocardial Infarction Registry. Between 1 January 2014 and 31 March
2016, 27 157 patients with 28 408 myocardial infarction events were recorded. To investigate
TIT, 7146 STEMI patients were selected who were treated with percutaneous coronary
intervention (PCI) within 24 hours of the beginning of the complaint and all of its
components were known. Results: Average follow-up was 740 +/- 346 days. The median
time of the TIT is 260 minutes, within which the earliest prehospital time was found
(median 205 minutes). The TIT influenced survival: if this time was less than 400
minutes, the 30-day and the 1-year deaths were 7.5% and 12.2%, respectively. In longer
TIT, higher mortality rate was found (9.2% versus 19.7%, respectively). Multivariate
analysis was performed for short (<30 days), medium (30-364 days) and long-term (>=
365 days) survival. Diabetes mellitus is a short-term prognostic factor, abnormal
creatinine, and severe coronary status have affected short and medium survival. PCI
was significant in terms of medium and long-term survival. Previous myocardial infarction
and TIT influenced the long-term survival significantly. Conclusions: In Hungary,
TIT is too long, and its dominant part falls within the prehospital period. The TIT
is an independent prognostic factor, so reducing this time can improve the long-term
prognosis of patients with ST-elevation myocardial infarction.