How Treatment Delay Matters in Acute MI

Results from the GRACE registry confirm higher death rates as time to revascularization increases.

Delays in treatment of acute MI are known to worsen cardiac outcomes. However, it is unclear whether treatment delays in primary percutaneous coronary intervention (PCI) are less detrimental than delays in fibrinolytic therapy. In the Global Registry of Acute Coronary Events (GRACE), a prospective cohort study of acute coronary syndromes involving 106 hospitals from 14 countries, 3959 STEMI patients (average age, 62 years; 25% women) who presented within 6 hours of symptom onset received reperfusion with either a fibrin-specific fibrinolytic drug or primary PCI.

Longer treatment delays were associated with higher 6-month mortality, both in patients treated with fibrinolytic agents and in those treated with primary PCI (P<0.001 for both cohor…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)