Alfredsson, Joakim

Engvall, Jan E

Janzon, Magnus

Maret, Eva

Swahn, Eva E

Tödt, Tim

English

PubMed

Tim Tödt

Eva Maret

Joakim Alfredsson

Magnus Janzon

Jan E Engvall

Eva E Swahn

Crossref

Journal of Cardiovascular Magnetic Resonance

Relationship between the duration of ischemia and final infarct size in STEMI patients treated with abciximab and primary PCI

Springer - Publisher Connector

POSTER PRESENTATION Open Access
Relationship between the duration of ischemia
and final infarct size in STEMI patients treated
with abciximab and primary PCI
Tim Tödt1*, Eva Maret2,3, Joakim Alfredsson1, Magnus Janzon1, Jan E Engvall2,4, Eva E Swahn1
From 15th Annual SCMR Scientific Sessions
Orlando, FL, USA. 2-5 February 2012
Summary
We studied 89 patients with first time myocardial
infarction and treated with primary PCI. There was only
a weak correlation between ischemia duration and final
myocardial scar size measured with ceMRI six weeks
later. Other factors like anterior infarction, a patent
artery pre-PCI and effects of reperfusion injury may
have had greater influence on infarct size than time-to-
treatment per se.
Background
Studies on the impact of time to treatment in primary
percutaneous coronary intervention (PCI) on myocardial
infarct size have yielded conflicting results. We investi-
gated the relation between the size of myocardial injury
and time from symptom onset to demonstration of an
open infarct related artery (IRA) in ST-elevation myo-
cardial infarction (STEMI) treated with primary PCI.
Methods
Between February 2006 and September 2007 we studied
89 STEMI patients treated with primary PCI and abcixi-
mab. Contrast enhanced magnetic resonance imaging
(ceMRI) was performed 4-8 weeks after the acute event.
Spearman correlation was computed for the potential
relationship between ischemic time and myocardial
injury. Multiple linear regression was used to determine
independent correlates of infarct size.
Results
An occluded artery (Thrombolysis In Myocardial Infarc-
tion, TIMI flow 0-1 at initial angiogram) was seen in 56
patients (63%). Abciximab was given to all but one
patient and 79 % were pre-treated with abciximab before
arriving at the cath-lab. The median time to a patent
artery was 193 minutes. There was a weak correlation
between time from symptom onset to an open culprit
artery and infarct size, r=0.21, p=0.05. Patients with a
patent artery within two hours of symptom onset
appeared to have smaller infarct size in absolute and
relative terms than those with longer ischemic times
although this did not reach statistical significance. In
multiple regression analyses LAD as the IRA, smoking
and an occluded vessel at the first angiogram, but not
ischemic time, correlated with infarct size.
Conclusions
In patients with STEMI treated with primary PCI we
found only a weak correlation between ischemic time
and infarct size. Since mean duration of ischemia was
more than three hours, other factors like anterior infarc-
tion, a patent artery pre-PCI and effects of reperfusion
injury may have had greater influence on infarct size
than time-to-treatment per se.
Funding
This work was supported by the Medical Research
Council of Southeast Sweden, the medical faculty of
Linköping University, the Swedish Heart-Lung founda-
tion, the Swedish Research Council, Futurum - the
Academy for health Care Jönköping County Council
and the Center of Medical Image Science and Visualiza-
tion at Linköping University Hospital.
Author details
1Department of Medical and Health Sciences, Division of Cardiology,
Linköping University, Linköping, Sweden. 2Center for Medical Image Science
1Department of Medical and Health Sciences, Division of Cardiology,
Linköping University, Linköping, Sweden
Full list of author information is available at the end of the article
Tödt et al. Journal of Cardiovascular Magnetic Resonance 2012, 14(Suppl 1):P21
http://www.jcmr-online.com/content/14/S1/P21
© 2012 Tödt et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
and Visualization, Linköping University, Linköping, Sweden. 3Department of
Clinical Physiology, Ryhov County Hospital, Jönköping, Sweden. 4Department
of Clinical Physiology UHL, Linköping University, Linköping, Sweden.
Published: 1 February 2012
doi:10.1186/1532-429X-14-S1-P21
Cite this article as: Tödt et al.: Relationship between the duration of
ischemia and final infarct size in STEMI patients treated with abciximab
and primary PCI. Journal of Cardiovascular Magnetic Resonance 2012 14
(Suppl 1):P21.
Submit your next manuscript to BioMed Central
and take full advantage of: 
• Convenient online submission
• Thorough peer review
• No space constraints or color figure charges
• Immediate publication on acceptance
• Inclusion in PubMed, CAS, Scopus and Google Scholar
• Research which is freely available for redistribution
Submit your manuscript at 
www.biomedcentral.com/submit
Figure 1 Subendocardial extent of infarct scar in the lateral wall of
the left ventricle six weeks post PCI.
Table 1 Multiple linear regression. Predictors of infarct
size (Scar ml).
Variable B (95% CI) P value
Age 0.27 (-0.39-0.59) .085
Occluded artery at first angiogram 10.9 (5.2-16.5) .0005
LAD as culprit artery 10.2 (4.8-15.6) .0005
Symptom to patent artery (minutes) 0.18 (-0.54-0.89) .62
Active smoker 7.9 (2.1-13.7) .008
Male sex 4.9 (-2.7-12.4) .20
Hypertension 3.9 (-2.2-10.2) .20
Diabetes 0.26 (-11.5-12.0) .96
B, regression coefficient. CI, confidence interval. LAD, left anterior descending
artery.
Tödt et al. Journal of Cardiovascular Magnetic Resonance 2012, 14(Suppl 1):P21
http://www.jcmr-online.com/content/14/S1/P21
Page 2 of 2


Tödt Tim

Maret Eva

Alfredsson Joakim

Janzon Magnus

Engvall Jan E

Swahn Eva E

Directory of Open Access Journals

http://doaj.org/search?source=%7B%22query%22%3A%7B%22bool%22%3A%7B%22must%22%3A%5B%7B%22term%22%3A%7B%22id%22%3A%22d9a04b6f433143cea57fb0300ef6e823%22%7D%7D%5D%7D%7D%7D

Relationship between the duration of ischemia and final infarct size in STEMI patients treated with abciximab and primary PCI

Abstract

Similar works

Full text

Available Versions

Crossref

Springer - Publisher Connector

Directory of Open Access Journals