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- María Cristina Barneto Valero, José Ramón Garmendia Leiza, Daniel Bautista Encarnación, Juan Vicente Benéit Montesinos, Antonio Fernández Ortiz, Aida Suárez Barrientos, José Luis García Klepzig, Cristina F... more
- SAMUR-PC, Madrid, España.
- Emergencias. 2016 Oct 1; 28 (5): 327-332.
ObjectivesTo explore circadian variation in the effectiveness of percutaneous transluminal coronary angioplasty (PTCA) to treat ST-elevation myocardial infarction (STEMI) To explore the effects of circardian variation on infarct extension and in-hospital complications.Material And MethodsObservational retrospective cohort study including patients with PTCA-treated STEMI in a tertiary care university hospital between March 2003 and August 2009. The independent variable of interest was the time of onset of STEMI symptoms, grouped in 6-hour time frames. The main outcome variable was PTCA effectiveness. Secondary outcome variables were infarct extension and the presence of in-hospital complications.ResultsA total of 522 patients records were studied. The mean (SD) age was 62.3 (13.6) years and 404 (77.4%) were men. The largest proportion of PTCA-treated STEMI cases first experienced symptoms between 6 AM and 12 PM (201 cases, 38.5%) (P<.001). PTCA was ineffective in 122 (23.4%). The 6 AM to 12 PM time frame was an independent predictor of PTCA ineffectiveness (odds ratio, 1.79; 95% CI, 1.09-2.94; P=.012). Onset in this interval was also associated with infarct extension but not with in-hospital complications.ConclusionA time of onset of STEMI between 6 AM and 12 PM predicts the ineffectiveness of PTCA and greater infarct extension but not in-hospital complications.
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