The relationship between symptom onset-to-needle time and
ischemic outcomes in patients with acute myocardial infarction
treated with primary PCI Observations from Prague-18 Study

J 2022

The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study

HROMADKA, Milan, Zuzana MOTOVSKA, Ota HLINOMAZ, Petr KALA, Ivo VARVAROVSKY et. al.

Basic information

Original name

The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study

Authors

HROMADKA, Milan (203 Czech Republic), Zuzana MOTOVSKA (203 Czech Republic, guarantor), Ota HLINOMAZ (203 Czech Republic, belonging to the institution), Petr KALA (203 Czech Republic, belonging to the institution), Ivo VARVAROVSKY (203 Czech Republic), Jaroslav DUSEK (203 Czech Republic), Michal SVOBODA (203 Czech Republic, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Frantisek TOUSEK (203 Czech Republic), Pavel JANSKY (203 Czech Republic), Stanislav SIMEK (203 Czech Republic), Marian BRANNY (203 Czech Republic), Jan MROZEK (203 Czech Republic), Roman MIKLÍK (203 Czech Republic, belonging to the institution), Richard ROKYTA (203 Czech Republic) and Petr WIDIMSKY (203 Czech Republic)

Edition

JOURNAL OF CARDIOLOGY, NETHERLANDS, ELSEVIER, 2022, 0914-5087

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.500

RIV identification code

RIV/00216224:14110/22:00128074

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.jjcc.2021.11.015

UT WoS

000821518300009

Keywords in English

Acute myocardial infarction; Symptoms onset to needle time; Risk stratification; P2Y12 inhibitors; Ischemic endpoints

Abstract

V originále

Objectives: Based on previous studies with clopidogrel, the time between acute myocardial infarction (AMI) symptoms onset and primary percutaneous coronary intervention (PCI) was proven as important prognostic factor. Our aim was to assess the relationship between symptoms onset to needle time (SNT) and procedural results and the occurrence of ischemic endpoints in primary angioplasty patients treated with potent P2Y12 inhibitors. Methods: A total of 1,131 out of 1,230 patients randomized to the Prague-18 study (prasugrel vs. ticagrelor in primary PCI) were divided into a high and a low-risk group. The effect of defined SNT on patients' ischemic endpoints and prognosis by their risk status at admission was tested. Results: The median SNT was 3.2 hours. Longer SNTs resulted in a more frequent incidence of TIMI flow <3 post PCI (p=0.015). There were significant differences in the occurrence of the combined ischemic endpoint among the compared SNT groups at 30 days (p=0.032), and 1 year (p=0.011), with the highest incidence in the <<= 1 h SNT group of patients. "Latecomers" (SNT>4 hs) in the high-risk group experienced more reinfarction within 1 year [OR (95% CI) 3.23 (1.09-9.62) p=0.035]; no difference was found in the low-risk group. Conclusions: In the era of intense antithrombotic medication, stratification of MI patients undergoing primary angioplasty, based on initial ischemic risk assessment affected prognosis more than symptom onset to needle time. Longer time delay was significantly related to increased incidence of ischemic events and all-cause mortality only in patients with high ischemic risk. (C) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Citovat

HROMADKA, Milan, Zuzana MOTOVSKA, Ota HLINOMAZ, Petr KALA, Ivo VARVAROVSKY, Jaroslav DUSEK, Michal SVOBODA, Jiří JARKOVSKÝ, Frantisek TOUSEK, Pavel JANSKY, Stanislav SIMEK, Marian BRANNY, Jan MROZEK, Roman MIKLÍK, Richard ROKYTA and Petr WIDIMSKY. The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study. JOURNAL OF CARDIOLOGY. NETHERLANDS: ELSEVIER, 2022, vol. 79, No 5, p. 1-8. ISSN 0914-5087. Available from: https://dx.doi.org/10.1016/j.jjcc.2021.11.015.

@article{2247545,
   author = {Hromadka, Milan and Motovska, Zuzana and Hlinomaz, Ota and Kala, Petr and Varvarovsky, Ivo and Dusek, Jaroslav and Svoboda, Michal and Jarkovský, Jiří and Tousek, Frantisek and Jansky, Pavel and Simek, Stanislav and Branny, Marian and Mrozek, Jan and Miklík, Roman and Rokyta, Richard and Widimsky, Petr},
   article_location = {NETHERLANDS},
   article_number = {5},
   doi = {http://dx.doi.org/10.1016/j.jjcc.2021.11.015},
   keywords = {Acute myocardial infarction; Symptoms onset to needle time; Risk stratification; P2Y12 inhibitors; Ischemic endpoints},
   language = {eng},
   issn = {0914-5087},
   journal = {JOURNAL OF CARDIOLOGY},
   title = {The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study},
   url = {https://www.sciencedirect.com/science/article/pii/S0914508721003385?via%3Dihub},
   volume = {79},
   year = {2022}
}

TY  - JOUR
ID  - 2247545
AU  - Hromadka, Milan - Motovska, Zuzana - Hlinomaz, Ota - Kala, Petr - Varvarovsky, Ivo - Dusek, Jaroslav - Svoboda, Michal - Jarkovský, Jiří - Tousek, Frantisek - Jansky, Pavel - Simek, Stanislav - Branny, Marian - Mrozek, Jan - Miklík, Roman - Rokyta, Richard - Widimsky, Petr
PY  - 2022
TI  - The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study
JF  - JOURNAL OF CARDIOLOGY
VL  - 79
IS  - 5
SP  - 1-8
EP  - 1-8
PB  - ELSEVIER
SN  - 09145087
KW  - Acute myocardial infarction
KW  - Symptoms onset to needle time
KW  - Risk stratification
KW  - P2Y12 inhibitors
KW  - Ischemic endpoints
UR  - https://www.sciencedirect.com/science/article/pii/S0914508721003385?via%3Dihub
N2  - Objectives: Based on previous studies with clopidogrel, the time between acute myocardial infarction (AMI) symptoms onset and primary percutaneous coronary intervention (PCI) was proven as important prognostic factor. Our aim was to assess the relationship between symptoms onset to needle time (SNT) and procedural results and the occurrence of ischemic endpoints in primary angioplasty patients treated with potent P2Y12 inhibitors. Methods: A total of 1,131 out of 1,230 patients randomized to the Prague-18 study (prasugrel vs. ticagrelor in primary PCI) were divided into a high and a low-risk group. The effect of defined SNT on patients' ischemic endpoints and prognosis by their risk status at admission was tested. Results: The median SNT was 3.2 hours. Longer SNTs resulted in a more frequent incidence of TIMI flow <3 post PCI (p=0.015). There were significant differences in the occurrence of the combined ischemic endpoint among the compared SNT groups at 30 days (p=0.032), and 1 year (p=0.011), with the highest incidence in the <<= 1 h SNT group of patients. "Latecomers" (SNT>4 hs) in the high-risk group experienced more reinfarction within 1 year [OR (95% CI) 3.23 (1.09-9.62) p=0.035]; no difference was found in the low-risk group. Conclusions: In the era of intense antithrombotic medication, stratification of MI patients undergoing primary angioplasty, based on initial ischemic risk assessment affected prognosis more than symptom onset to needle time. Longer time delay was significantly related to increased incidence of ischemic events and all-cause mortality only in patients with high ischemic risk. (C) 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
ER  -

HROMADKA, Milan, Zuzana MOTOVSKA, Ota HLINOMAZ, Petr KALA, Ivo VARVAROVSKY, Jaroslav DUSEK, Michal SVOBODA, Jiří JARKOVSKÝ, Frantisek TOUSEK, Pavel JANSKY, Stanislav SIMEK, Marian BRANNY, Jan MROZEK, Roman MIKLÍK, Richard ROKYTA and Petr WIDIMSKY. The relationship between symptom onset-to-needle time and ischemic outcomes in patients with acute myocardial infarction treated with primary PCI Observations from Prague-18 Study. \textit{JOURNAL OF CARDIOLOGY}. NETHERLANDS: ELSEVIER, 2022, vol.~79, No~5, p.~1-8. ISSN~0914-5087. Available from: https://dx.doi.org/10.1016/j.jjcc.2021.11.015.

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