Key result
In STEMI patients with renal dysfunction, a total ischemic time greater than 6 hours significantly increased the incidence of in-hospital pulmonary edema and cardiogenic shock compared to 6 hours or less (16.1% vs 3.7%, p=0.034).
Why the study?
The study was conducted to examine the impact of total ischemic time on in-hospital complications in acute STEMI patients with renal dysfunction.
Does a total ischemic time > 6 hours increase in-hospital complications (pulmonary edema and cardiogenic shock) in STEMI patients with renal dysfunction?
Observational (n=116)
No
Does a total ischemic time > 6 hours increase in-hospital complications (pulmonary edema and cardiogenic shock) in STEMI patients with renal dysfunction?
In STEMI patients with renal dysfunction, a total ischemic time greater than 6 hours is associated with a significantly higher risk of in-hospital pulmonary edema and cardiogenic shock.
Answers are grounded in this paper and cite their sources.
May warrant TIT minimization in STEMI with RD; leaves open need for prospective validation before practice change.
Aim The purpose of this study was to examine the impact of total ischemic time (TIT) on in-hospital complications in acute ST-elevation myocardial infarction (STEMI) patients with renal dysfunction (RD). Methods The study included a total of 116 patients. All patients underwent percutaneous coronary intervention. Glomerular filtration rate (GFR) was < 60 ml/min/1.73 m2 in all patients. The patients were split into two groups based on the TIT value. All eligible patients were assigned to two groups according to TIT: Group 1 comprised 54 patients with ≤ 6-hour TIT and Group 2 consisted of 62 patients with > 6-hour TIT. The groups' other characteristics were similar. The composite rate of pulmonary edema and cardiogenic shock were compared between groups. Results The mean TIT in Group 1 was 4.37 ± 1.35 and in Group 2 was 9.03 ± 1.59 (p < 0.0001). The incidence of pulmonary edema or cardiogenic shock was higher in Group 2 than in Group 1: 16.1% and 3.7%, respectively (p = 0.034). Conclusion STEMI patients with RD and higher TIT were more likely to develop pulmonary edema and cardiogenic shock.
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Petrosyan et al. (2023) conducted an observational in ST-elevation myocardial infarction (STEMI) with renal dysfunction (n=116). Total ischemic time > 6 hours vs. Total ischemic time ≤ 6 hours was evaluated on Composite rate of pulmonary edema and cardiogenic shock (p=0.034). In STEMI patients with renal dysfunction, a total ischemic time greater than 6 hours significantly increased the incidence of in-hospital pulmonary edema and cardiogenic shock compared to 6 hours or less (16.1% vs 3.7%, p=0.034).
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