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ST분절 상승 심근경색증 환자에서 시간 지연이 사망률에 미치는 영향
박용규 ( Yong Kyu Park ),정진옥 ( Jin Ok Jeong ),박재호 ( Jae Ho Park ),이현석 ( Hyeon Seok Lee ),이영달 ( Young Dal Lee ),최웅림 ( Ung Lim Choi ),진선아 ( Sun Ah Jin ),신성균 ( Sung Kyun Sin ),김준형 ( Jun Hyung Kim ),박재형 ( Ja 대한내과학회 2011 대한내과학회지 Vol.81 No.2
Background/Aims: The delay between the onset of myocardial infarction symptoms and primary percutaneous coronary intervention (PCI) is an important prognostic factor in patients with ST-segment elevation acute myocardial infarction (STEMI).We reviewed this delay in patients with STEMI and analyzed clinical outcomes. Methods: The study enrolled 3,399 patients (age, 61.4±12.8 years; 25.6% women) with STEMI who underwent primary PCIwithin 12 hours of symptom onset between October 2005 and February 2008 from the Korea Acute Myocardial Infarction Registry.The patients were divided into two groups according to the symptom-to-balloon time: group I (≤ 3 hours, n=955) and group II (>3 hours, n=2444). The in-hospital mortality rates and 1-year mortality and major adverse cardiac event (MACE) rates werecompared between the two groups. Results: The mean time interval from the onset of symptoms to arrival at the emergency room (ER) was 188.0±133.6 minutes(median, 152 minutes). The mean time interval from the ER to reperfusion (door-to-balloon time) was 97.8±67.9 minutes (median,80 minutes). The mean time interval from the onset of symptoms to reperfusion (symptom-to-balloon time) was 285.8±146.2minutes (median 250 minutes). The in-hospital mortality rate was significantly lower in group I as compared with group II (3.6%versus 5.2%, p=0.044). The 1-year mortality rate was also significantly lower in group I (4.7% versus 7.2%, p=0.012), while the1-year MACE rate was not significantly different between groups (17.9% versus 20.4%, p=0.179). Conclusions: This study demonstrates that there is a significant pre-hospital time delay in patients with STEMI in Korea and this time delay is associated with increased 1-year mortality. (Korean J Med 2011;81:199-207)
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