Acute Coronary Syndromes

E131JACC March 12, 2013Volume 61, Issue 10

myocardial Blush grade and morTaliTy afTer pharmaco invasive Therapy wiTh TenecTeplase adminisTered up To Three or from Three To six hours are similar

Poster ContributionsPoster Sessions, Expo NorthSunday, March 10, 2013, 9:45 a.m.-10:30 a.m.

Session Title: ACS Therapy: No Reflow and Improving OutcomesAbstract Category: 3. Acute Coronary Syndromes: TherapyPresentation Number: 1214-185

Authors: Livia N. Matos, Antonio C. Carvalho, Adriano H. Barbosa, Iran Goncalves Jr, Eryca V. Jesus, Juscelio T. Souza Filho, Amaury Amaral, Luiz C. Wilke, Vinicius Vitro, Edson Stefanini, Euclides M. Barros Jr, Claudia M. Alves, Federal University of Sao Paulo, Sao Paulo, Brazil

introduction: Adequate myocardial blush grade (MBG) observed after reperfusion therapy in ST elevation myocardial infarction (STEMI) treatment is considered a success indicator. On the other hand, it is well established that the earlier we treat STEMI patients the better clinical results and mortality will do. With pharmaco invasive therapy (PIT) it is still unclear whether MBG and clinical results will be different when PIT is done either up to three or from three to six hours from clinical onset.

aims: To determine whether PIT provides different MBG and mortality results when reperfusion therapy is done up to three or from three to six hours after symptoms onset.

methods: We evaluated 393 consecutive individuals who had STEMI treatment within 6 hours and were referenced from low complexity health care units to a tertiary cardiology hub after tenecteplase (TNK). TNK was the only lytic used and cardiac cath was performed routinely from 3 to 24 hours after lysis or as rescue. Coronary microvascular patency was considered present when MBG evaluated at the beginning of angiography was two or three and absent if zero or one. Statistical significance was set as P<0.05.

results: One hundred ninety-eight individuals were treated within three hours (149 men, 56.8 ± 11.3 years-old) and 195 were treated from three to six hours from symptoms onset (137 men, 58.8 ± 11.9 years-old); there was no difference in MBG two or three (46.9% vs. 48.4%, P>0.05) nor in hospital mortality (5.0% vs. 5.6%, P>0.05) between the two treatment groups.

conclusion: In this cohort there was no difference in adequate MBG and mortality among STEMI patients treated with PIT within 3 and from 3 to 6 hours after symptoms onset.