Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events.

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Abstract Text:

B Nallamothu,K A A Fox,B M Kennelly,F Van de Werf,J M Gore,P G Steg,C B Granger,O H Dabbous,E Kline-Rogers,K A Eagle, ,B Nallamothu,K A A Fox,B M Kennelly,F Van de Werf,J M Gore,P G Steg,C B Granger,O H Dabbous,E Kline-Rogers,K A Eagle, ,

OBJECTIVE: Treatment delays may result in different clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who receive fibrinolytic therapy vs primary percutaneous coronary intervention (PCI). The aim of this analysis was to examine how treatment delays relate to 6-month mortality in reperfusion-treated patients enrolled in the Global Registry of Acute Coronary Events (GRACE). DESIGN: Prospective, observational cohort study. SETTING: 106 hospitals in 14 countries. PATIENTS: 3959 patients who presented with STEMI within 6 h of symptom onset and received reperfusion with either a fibrin-specific fibrinolytic drug or primary PCI. MAIN OUTCOME MEASURES: 6-month mortality. METHODS: Multivariable logistic regression was used to assess the relationship between outcomes and treatment delay separately in each cohort, with time modelled with a quadratic term after adjusting for covariates from the GRACE risk score. RESULTS: A total of 1786 (45.1%) patients received fibrinolytic therapy, and 2173 (54.9%) underwent primary PCI. After multivariable adjustment, longer treatment delays were associated with a higher 6-month mortality in both fibrinolytic therapy and primary PCI patients (p<0.001 for both cohorts). For patients who received fibrinolytic therapy, 6-month mortality increased by 0.30% per 10-min delay in door-to-needle time between 30 and 60 min compared with 0.18% per 10-min delay in door-to-balloon time between 90 and 150 min for patients undergoing primary PCI. CONCLUSIONS: Treatment delays in reperfusion therapy are associated with higher 6-month mortality, but this relationship may be even more critical in patients receiving fibrinolytic therapy.

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Publishing Authors By Initials

B Nallamothu,KA Fox,BM Kennelly,F Van de Werf,JM Gore,PG Steg,CB Granger,OH Dabbous,E Kline-Rogers,KA Eagle, ,B Nallamothu,KA Fox,BM Kennelly,F Van de Werf,JM Gore,PG Steg,CB Granger,OH Dabbous,E Kline-Rogers,KA Eagle, ,

For similar abstracts research abstracts see: abstracts research

PUBMED ID PMID:

MEDLINE DATE:

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Heart (British Cardiac Society)

VOLUME: 93

Page Numbers: 1552-5

Journal Abbreviation: Heart

ISSN: 1468-201X

DAY: 25

MONTH: 06

YEAR: 2007

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 9602087

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Keywords Mesh Terms:

KEYWORDS:

MESH TERMS:

Chemical & Substance for Abstract: Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events.

AFFILIATION: VA Health Services Research & Development Center of Excellence, Ann Arbor VA Medical Center, Ann Arbor, USA.

Country: England

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Heart

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention The Global Registry of Acute Coronary Events Related Publications

• A systematic review of gender differences in mortality after coronary artery bypass graft surgery and percutaneous coronary interventions.
• Acute aortic dissection.
• Bilateral ocular disease as the initial presentation of malignant lymphoma.
• Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies.
• Coronary artery disease in India: challenges and opportunities.
• Episcleral melanoma without conjunctival or uveal involvement.
• Free flow. Cardiac facility design ends wayfinding confusion and improves throughput.
• Impact of duty hours restrictions on quality of care and clinical outcomes.
• Interaction of digoxin with antacid constituents.
• Lermoyez' syndrome; an allergic disease.
• Medication adherence following coronary artery bypass graft surgery: assessment of beliefs and attitudes.
• New vistas. Saluting the best in hospital construction teamwork.
• On a higher plane. Medical center advances with Planetree model.
• Orchard fresh. Greenfield site provides home for newest Kaiser facility.
• Outside the box. Designers come up with new angles to distinguish facility.
• Pooling speed information in complex tasks: estimation of average speed and detection of nonplanarity.
• Practice guidelines: will they have an impact in high-tech cardiology?
• Primary acquired melanosis of the conjunctiva: experience with 311 eyes.
• Primary acquired melanosis of the conjunctiva: risks for progression to melanoma in 311 eyes. The 2006 Lorenz E. Zimmerman lecture.
• Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events.
• Reply.
• Specific and rational therapy in otolaryngology.
• Stage by stage. New women's hospital targets every need.
• Streptomycin therapy of tuberculosis.
• Symptomatic elongated styloid process; report of two cases of styloid process-carotid artery syndrome with operation.
• Tear size and location impacts false lumen pressure in an ex vivo model of chronic type B aortic dissection.
• The mode of action of penicillin in relation to its therapeutic use.
• The recovery of bacteria from the toxic effects of penicillin.
• The use of antithrombotics for acute coronary syndromes in the emergency department: considerations and impact.
• Use of Anticoagulants in ST-Segment Elevation Myocardial Infarction Patients; A Focus on Low-Molecular-Weight Heparin.