Shorter door-to-balloon time, better long-term clinical outcomes in ST-segment elevation myocardial infarction patients: J-MINUET substudy.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nishio Ryota, Ogita Manabu, Suwa Satoru, Nakao Koichi, Ozaki Yukio, Kimura Kazuo, Ako Junya, Noguchi Teruo, Fujimoto Kazuteru, Dai Kazuoki, Morita Takashi, Shimizu Wataru, Saito Yoshihiko, Hirohata Atsushi, Morita Yasuhiro, Inoue Teruo, Okamura Atsunori, Mano Toshiaki, Wake Minoru, Tanabe Kengo, Shibata Yoshisato, Tsutsui Hiroshi, Funayama Hiroshi, Kokubu Nobuaki, Kozuma Ken, Uemura Shirou, Toubaru Tetsuya, Saku Keijiro, Oshima Shigeru, Yoshikawa Yusuke, Ogata Soshiro, Nishimura Kunihiro, Miyamoto Yoshihiro, Ishihara Masaharu, J-MINUET investigators
Аннотация
METHODS: We investigated 3283 consecutive patients with acute myocardial infarction selected from a prospective, nationwide, multicenter registry (J-MINUET database comprising 28 institutions in Japan between July 2012 and March 2014. Among the study population, we analyzed 1639 STEMI patients who had PPCI within 12 h of onset. Patients were stratified into four groups (DTB time < 45 min, 45-60 min, 61-90 min, >90 min. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure, and urgent revascularization for unstable angina up to 3 years. We performed landmark analysis for incidence of the primary endpoint from 31 days to 3 years among the four groups.
RESULTS: The primary endpoint rate from 31 days to 3 years increased significantly and time-dependently with DTB time (10.2 % vs. 15.3 % vs. 16.2 % vs. 19.3 %, respectively; log-rank p = 0.0129. Higher logarithm-transformed DTB time was associated with greater risk of a primary endpoint from 31 days to 3 years, and the increased number of adverse long-term clinical outcomes persisted even after adjusting for other independent variables.
CONCLUSION: Shorter DTB time was associated with better long-term clinical outcomes in STEMI patients treated with PPCI in contemporary clinical practice. Further efforts to shorten DTB time are recommended to improve long-term clinical outcomes in STEMI patients.
TRIAL REGISTRATION: UMIN Unique trial Number: UMIN000010037.