Relationship Between the Door-to-TIMI-3 Flow Time and the Infarct Size in Patients Suffering From Acute Myocardial Infarction : Analysis Based on the Fibrinolysis and Subsequent Transluminal (FAST-3) Trial

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Background The purpose of this study was to use the findings of a fibrinolysis and subsequent transluminal trial (FAST-3) to evaluate the association between the target time for obtaining a thrombolysis in myocardial infarction (TIMI)-3 flow after arrival at the emergency room with acute myocardial infarction (AMI) and the degree of myocardial salvage. Methods and Results The FAST-3 trial was administered to 100 patients suffering from AMI. Ranges in the door-to-TIMI-3 flow time (D-T3-time : TIMI-3 flow after arrival at the emergency room) according to quartile were as follows : 30-54min (quartile 1), 55-77min (quartile 2), 78-120min (quartile 3) and 121-330min (quartile 4). Peak creatine kinase (CK), peak CK-MB, and peak troponin-T values increased in a stepwise fashion across the increasing quartiles of D-T3-time. The left ventricular enddiastolic volume index at 30 days after the start of treatment showed low values for quartile 1. In multiple logistic regression analyses for independent predictors of myocardial damage, the adjusted odds ratios for myocardial damage (peak CK > 3,OOOU/L) in quartiles 3 and 4 of the D-T3-time were 4.0 (95% CI : 1.0-16.1) and 7.0 (95% confidence interval (CI) : 1.4-36.0), respectively. Conclusions These findings suggest that physicians should monitor the D-T3-time for at least 55 min.
社団法人日本循環器学会の論文
2004-03-20