• Jean-Michel Juliard, Laurent J Feldman, Jean-Louis Golmard, Dominique Himbert, Hakim Benamer, Tinouche Haghighat, Daniel Karila-Cohen, Pierre Aubry, Alec Vahanian, and Ph Gabriel Steg.
• Cardiology Department, Hôpital Bichat, AP-HP, 46 rue Henri Huchard, 75877 Paris Cedex 18, France. jean-michel.juliard@bch.ap-hop-paris.fr
• Am. J. Cardiol. 2003 Jun 15;91(12):1401-5.

AbstractFor primary angioplasty of acute myocardial infarction (AMI), the relation of treatment benefit and time has been debated. The present study aimed to evaluate, in a single-center cohort of patients with ST-segment elevation AMI, which time intervals were carefully and consistently measured, and the relations among ischemic time, in-hospital delays, and in-hospital survival. We included 499 patients (mean age 59 years; 80% men) who underwent successful primary percutaneous transluminal coronary angioplasty (PTCA) for AMI admitted < or =6 hours after symptom onset. The population was divided into tertiles with respect to time between onset of symptoms and admission, onset of symptoms to Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow, and time from admission to TIMI grade 3 flow. Univariate analysis followed by multiple logistic regression was performed using the variables linked to mortality in the univariate analysis to assess the relation between predictor variables and in-hospital mortality. The in-hospital mortality rate was 3.2%. There was no significant relation between the various tertiles of time intervals and in-hospital mortality. After linear logistic regression, only age (odds ratio [OR] 1.79 per 10 years), female gender (OR 3.56), and door-to-TIMI 3 time (OR 1.27 per 15 minutes) were independently correlated with in-hospital mortality.

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