Effect of time to treatment and age on one year mortality in acute STEMI: difference between thrombolysis and primary percutaneous coronary intervention

Labriolle, Axel de; Pacouret, G; Giraudeau, Bruno; Fremont, B.; Desveaux, B; Quilliet, L; Fauchier, Laurent; Charbonnier, B

doi:10.1016/s1875-2136(08)70255-9

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…As an antioxidant in the body, bilirubin is involved in the occurrence and development of myocardial infarction and plays an antioxidative role. Okuhara et al showed that compared with non-AMI patients, the serum bilirubin concentration and Fe2 in AMI patients increased temporarily 18–21 hours after the onset of the disease 12. Elevated bilirubin has antioxidant capacity and the ability to remove peroxides, which can prevent the deterioration of disease.…”

Section: Discussionmentioning

confidence: 99%

“…In an attempt to identify patients with STEMI at high risk of unfavourable outcomes, several predictors of adverse events in STEMI have been investigated. Research indicates that older age,2 B-type natriuretic peptide (BNP), D-dimer, uric acid and thrombolysis myocardial infarction (TIMI) risk score are associated with a higher risk of adverse events in patients with STEMI 3–6. However, there is no literature report on the combination of white cell count (WCC) and total bilirubin (TB) in the guiding significance for the prognosis of STEMI.…”

Section: Introductionmentioning

confidence: 99%

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Predicting value of white cell count and total bilirubin on clinical outcomes in patients with ST-elevation myocardial infarction following percutaneous coronary intervention: a cohort study

Tuxun

Zhao²,

Xiang

et al. 2020

BMJ Open

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ObjectivesA combined equation based on white cell count (WCC) and total bilirubin (TB) was assessed for its ability to predict adverse clinical outcomes in patients with acute ST-segment elevation myocardial infarction (STEMI) with primary percutaneous coronary intervention (PCI).DesignA single-centre, prospective cohort study.SettingThe First Affiliated Hospital of Xinjiang Medical University.MethodA total of 615 patients with STEMI postprimary PCI were enrolled. WCC and TB were collected at admission. Logistic regression was used to determine the combined equation. The primary endpoints were in-hospital mortality and major adverse cardiovascular events (MACE), which composed of cardiac death, cardiac shock, malignant arrhythmia (ventricular tachycardia, ventricular fibrillation), severe cardiac insufficiency, non-fatal myocardial infarction, angina pectoris readmission, severe cardiac insufficiency (cardiac III–IV level), stent restenosis and target vessels revascularisation during the hospitalisation and 36 months follow-up period.Result77 patients occurred in MACE during the hospitalisation (17 in-hospital mortality). WCC and TB were taken as an independent variables to make a category of logistic regression analysis of in-hospital MACE, the logistic regression model was: logit (P)=−8.00+0.265 WCC+0.077 TB, the combination of WCC and TB was more valuable on evaluating the in-hospital mortality (area under the curve 0.804, 95% CI 0.678 to 0.929, p<0.001). Multivariate logistic regression analysis showed that combined detection was an independent risk factor for in-hospital MACE (OR 5.85, 95% CI 3.425 to 9.990, p=0.032). During the follow-up period, 172 patients (29.5%) developed MACE. But the combined detection did not predict the long-term clinical outcome.ConclusionThe combination of WCC and TB is an independent predictor for in-hospital outcomes in patients with STEMI than single detection.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predicting value of white cell count and total bilirubin on clinical outcomes in patients with ST-elevation myocardial infarction following percutaneous coronary intervention: a cohort study

Tuxun

Zhao²,

Xiang

et al. 2020

BMJ Open

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“…20 In addition, prompt diagnosis and adequate treatment influence the occurrence of long-term fatal 21 and non-fatal 22 complications. Timely prescription may also be a marker of adequate monitoring and agile decision-making in the emergency department.…”

Section: Discussionmentioning

confidence: 99%

Time-To-Treatment of Acute Coronary Syndrome and First Contact in the ERICO Study

Santos

Goulart

Kisukuri

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundTo the best of our knowledge, there are no studies evaluating the influence of the unit of the first contact on the frequency and time of pharmacological treatment during an acute coronary syndrome (ACS) event.ObjectivesThe main objective was to investigate if the unit of first contact influenced the frequency and time of aspirin treatment in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study.MethodsWe analyzed the pharmacological treatment time in 830 ERICO participants - 700 individuals for whom the hospital was the unit of first contact and 130 who initially sought primary care units. We built logistic regression models to study whether the unit of first contact was associated with a treatment time of less than three hours.ResultsIndividuals who went to primary care units received the first aspirin dose in those units in 75.6% of the cases. The remaining 24.4% received aspirin at the hospital. Despite this finding, individuals from primary care still had aspirin administered within three hours more frequently than those who went to the hospital (76.8% vs 52.6%; p<0.001 and 100% vs. 70.7%; p=0.001 for non ST-elevation ACS and ST-elevation myocardial infarction, respectively). In adjusted models, individuals coming from primary care were more likely to receive aspirin more quickly (odds ratio: 3.66; 95% confidence interval: 2.06-6.51).ConclusionsIn our setting, individuals from primary care were more likely to receive aspirin earlier. Enhancing the ability of primary care units to provide early treatment and safe transportation may be beneficial in similar settings.

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“…We set the prevalence of higher-risk characteristics (Killip class >1) to be 25% on the basis of the reported prevalence in STEMI cohorts. [5][6][7][8][9][10][11][12][19][20][21] We considered the remaining 75% to be low risk. We then varied the distribution of higher-risk patients between arms.…”

Section: Simple Calculation Of Number Needing To Be Diverted To Abolimentioning

confidence: 99%

“…Many show no significant reduction in mortality in the PPCI group compared with the fibrinolysis group. [5][6][7][8][9][10][11][12] A metaanalysis of such registries has revealed no significant difference in long-term mortality between patients allocated to PPCI and those allocated to fibrinolysis. 13 The greater size, universal inclusivity, and wider geographical spread of real-world data form a significant challenge to the RCT-based assumption that PPCI does indeed give genuine long-term benefits.…”

mentioning

confidence: 99%

Why Does Primary Angioplasty Not Work in Registries? Quantifying the Susceptibility of Real-World Comparative Effectiveness Data to Allocation Bias

Sen

Davies

Malik

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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The online-only Data Supplement is available at http://circoutcomes.ahajournals.org/lookup/suppl/ Background-Meta-analysis of registries (comparative effectiveness research) shows that primary angioplasty and fibrinolysis have equivalent real-world survival. Yet, randomized, controlled trials consistently find primary angioplasty superior. Can unequal allocation of higher-risk patients in registries have masked primary angioplasty benefit? Methods and Results-First, we constructed a model to demonstrate the potential effect of allocation bias. We then analyzed published registries (55 022 patients) for allocation of higher-risk patients (Killip class ≥1) to determine whether the choice of reperfusion therapy was affected by the risk level of the patient. Meta-regression was used to examine the relationship between differences in allocation of high-risk patient to primary angioplasty or fibrinolysis and mortality. Initial modeling suggested that registry outcomes are sensitive to allocation bias of high-risk patients. Across the registries, the therapy receiving excess high-risk patients had worse mortality. Unequal distribution of high-risk status accounted for most of the between-registry variance (adjusted R 2 meta =83.1%). Accounting for differential allocation of higher-risk patients, primary angioplasty gave 22% lower mortality (odds ratio, 0.78; 95% confidence interval, 0.64-0.97; P=0.029). We derive a formula, called the number needed to abolish, highlighting situations in which comparative effectiveness studies are particularly vulnerable to this bias. Conclusions-In ST-segment elevation myocardial infarction, clinicians' preference for management of a few high-risk patients can shift mortality substantially. Comparative effectiveness research in any disease is vulnerable to this, especially diseases with an immediately identifiable high-risk subgroup that clinicians prefer to allocate to 1 therapy. For this reason, preliminary indications from registry-based comparative effectiveness research should be definitively tested by randomized, controlled trials. (Circ Cardiovasc Qual Outcomes. 2012;5:759-766.)

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Effect of time to treatment and age on one year mortality in acute STEMI: difference between thrombolysis and primary percutaneous coronary intervention

Cited by 4 publications

References 24 publications

Predicting value of white cell count and total bilirubin on clinical outcomes in patients with ST-elevation myocardial infarction following percutaneous coronary intervention: a cohort study

Predicting value of white cell count and total bilirubin on clinical outcomes in patients with ST-elevation myocardial infarction following percutaneous coronary intervention: a cohort study

Time-To-Treatment of Acute Coronary Syndrome and First Contact in the ERICO Study

Why Does Primary Angioplasty Not Work in Registries? Quantifying the Susceptibility of Real-World Comparative Effectiveness Data to Allocation Bias

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