• 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 Fernández Pérez, María Dolores Aguilar García, and Borja Ibáñez.
• 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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