Effect of transfer delay on left ventricular function after primary PCI for ST elevation myocardial infarction

Area of Science:

• Cardiology
• Interventional Cardiology
• Acute Myocardial Infarction

Background:

• Primary percutaneous coronary intervention (PPCI) is the preferred treatment for ST Elevation Myocardial Infarction (STEMI).
• Transferring STEMI patients to a PCI-capable center can cause treatment delays.
• The impact of transfer delays on LV function and outcomes in PPCI patients requires investigation.

Purpose of the Study:

• To evaluate the influence of transfer delay on left ventricular (LV) function and clinical outcomes in patients undergoing PPCI for STEMI.

Main Methods:

• 113 consecutive PPCI patients were analyzed: 69 presented directly, 44 were transferred.
• Echocardiography assessed LV function via Wall Motion Score Index (WMSI) at day 1 and 6 weeks.
• Long-term clinical events were followed for a mean of 3.51 years.

Main Results:

• No significant difference in initial WMSI between direct and transfer patients.
• Significant WMSI improvement in both groups by 6 weeks.
• Longer pain-to-balloon time, LAD stenosis, and initial low TIMI flow predicted LV dysfunction; no difference in clinical events during follow-up.

Conclusions:

• Transferred PPCI patients exhibit comparable LV function and long-term clinical outcomes to direct presenters.
• Transfer delay for PPCI in STEMI does not appear to compromise patient recovery or prognosis.