Naslov
IS IT TIME TO CHANGE OUR STEMI TERMINOLOGY? SHIFTING FROM DOOR-TO-BALLOON TO DOOR-TO-DEVICE TIME.

Autori
Hadžibegović, Irzal ; Prvulović, Đeiti ; Vujeva, Božo ; Gabaldo, Krešimir ; Samardžić, Pejo

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Cardiologia Croatica 2012 ; 7(suppl.1) / - , 2012

Skup
9.KONGRES HRVATSKOGA KARDIOLOŠKOG DRUŠTVA s međunarodnim sudjelovanjem

Mjesto i datum
Opatija, Hrvatska, 13.10.2012. - 16.10.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Stemy terminology ; experience

Sažetak
Background: Restoration of TIMI 3 flow in the infarct related artery within 120 minutes of first medical contact in a STEMI patient (90 minutes for large anterior wall STEMI) is widely adopted by the guidelines. Door-to-balloon time is accepted as a quality control tool that assesses efforts of in-hospital and cath lab delays minimization. Door-to-balloon remains in the STEMI terminology despite the fact that many STEMI patients achieve TIMI 3 flow without a balloon. We explored how TIMI 3 flow was established in our STEMI patients treated with primary PCI in a 2 year period. Patients and methods: In all, clinical and TIMI 3 flow restorement data from 82 patients who received primary PCI during regular working hours during 2010 and 2011 in General hospital Slavonski Brod, Croatia, were analyzed. Median age was 66 years and 66% of patients were male. Diabetes was present in 18% of patients. Median pain to first medical contact time was 170 minutes. TIMI 3 flow was established or found on urgent angiography in 74 (90%) patients. Results: Patent infarct related artery with TIMI 3 flow was found by urgent angiography in 16 (22%) patients. TIMI 3 flow was achieved by an intravascular device (wire, balloon, or aspiration catheter) in 58 (78%) patients. TIMI 3 flow was restored by an aspiration catheter in 38% of patients, whereas balloon and wire alone established TIMI 3 flow in 32% and 8% of cases, respectively. Use of aspiration device resulted in higher frequencies of upfront GP IIb-IIIa inhibitors use. In-hospital mortality was 6.1%. All patients with restored TIMI 3 flow and lethal in-hospital outcome received balloon inflation as a reperfusion method. Conclusion: Our experience showed that only one third of all STEMI patients treated with primary PCI achieved TIMI 3 flow after balloon inflation. Since TIMI 3 flow in almost half of patients was achieved by an aspiration catheter or wire alone we suggest routine use of the term door-to-device time in STEMI management.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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