• Gregoire Rangé, Saint Etienne Christophe C Cardiology Department, centre hospitalo-universitaire de Tours, 37170 Chambray-lès-Tours, France., Pierre Marcollet, Stephan Chassaing, Philippe Dequenne, Radwan Hakim, Jean Capsec, Christophe Laure, Sandra Gautier, Franck Albert, Lucile Godillon, Pelle Stolt, Pascal Motreff, and Leslie Grammatico-Guillon.
• Cardiology Department, Les Hôpitaux de Chartres, 4, rue Claude-Bernard, 28630 Le Coudray, France. Electronic address: grange@ch-chartres.fr.
• Arch Cardiovasc Dis. 2019 Jan 1; 112 (1): 3-11.

BackgroundIt is critical to minimize the time between the first medical contact and primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.AimsTo identify factors associated with a delay of>120min between first medical contact and primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.MethodsData were analysed from a regional French registry of patients undergoing coronary angioplasty for ST-segment elevation myocardial infarction<24h after symptom onset. Patients (n=2081) were grouped according to transfer times from first medical contact to primary percutaneous coronary intervention:>120min; or≤120min. Independent predictors of delay were identified by univariate and multivariable analyses.ResultsThe median transfer time from first medical contact to primary percutaneous coronary intervention was 112min; 892 patients (42.9%) had a transfer time>120min. A delay of>120min was significantly associated with:≥75km distance from interventional cardiology centre at symptom onset (odds ratio 7.9); more than one medical practitioner involved before interventional cardiology centre (odds ratio 4.5); first admission to a hospital without an interventional cardiology centre (odds ratio 2.9); absence of emergency call (odds ratio 1.6); ≥90min between symptom onset and first medical contact (odds ratio 1.3); Killip class at admission>1 (odds ratio 1.8); lateral ischaemia (odds ratio 1.8); diabetes mellitus (odds ratio 1.6); and hypertension (odds ratio 1.3).ConclusionsIn ST-segment elevation myocardial infarction, a transfer time from first medical contact to primary percutaneous coronary intervention of>120min was associated with geographic, systemic and comorbid factors, several of which appear reasonably actionable.Copyright © 2018 Elsevier Masson SAS. All rights reserved.

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