Observational studyJournal of the American Heart Association2014
Delay from first medical contact to primary PCI and all-cause mortality: a nationwide study of patients with ST-elevation myocardial infarction.
Observational study in Journal of the American Heart Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 78 citations in OpenAlex.
- Implementing the GWTG-CAD Program in Mexico: Feasibility, Challenges and Lessons Learned for Acute and Secondary Prevention and Management.Journal of the American Heart Association · 2026Article
- Relationship of Distance to PCI Center With In-Hospital Mortality After STEMI: Insights From a Rural Regional STEMI Network.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Modelling the coverage gap in percutaneous coronary intervention in LMIC: a geospatial analysis of cath lab coverage in Indonesia.Open heart · 2026Article
- Recognition of worsening heart failure symptoms, help-seeking attitudes, and time-to-presentation in chronic heart failure: a single-center KAP study in China.Frontiers in cardiovascular medicine · 2026Article
- Effectiveness of fully immersive virtual reality-based simulation training on objective knowledge acquisition in acute coronary syndrome/ST-elevation myocardial infarction emergency management: a pre-post-intervention study.European heart journal. Digital health · 2026Article
- Interhospital transfer versus direct admission for percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction: a systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Review
- Barriers to Timely Percutaneous Coronary Intervention (PCI) in Rural vs. Urban Settings: A Health System Approach.Cureus · 2025Article
- Article
- Effects of intravenous pulse methylprednisolone in neuromyelitis optica during the acute phase.Annals of clinical and translational neurology · 2024Article
- Presentation, management, and early outcomes of young acute coronary syndrome patients- analysis of 23,560 South Asian patients from 2012 to 2021.BMC cardiovascular disorders · 2024Article
- Optimal timing of pharmacoinvasive strategy and its impact on clinical and economic outcomes in patients with ST-elevation myocardial infarction: a real-world perspective.Frontiers in cardiovascular medicine · 2024Article
- Gender disparities in the mediating role of symptom knowledge level in reducing acute coronary syndrome (ACS) decision delay: Findings from a community-based study in China.BMC emergency medicine · 2023Article
- Delayed PCI is not beneficial for STEMI patients with impaired renal function: a retrospective cohort study.BMC cardiovascular disorders · 2023Article
- Effect of Covid-19 pandemic process on STEMI patients timeline.International journal of clinical practice · 2021Article
- Correlates of Delayed Initial Contact to Emergency Services among Patients with Suspected ST-Elevation Myocardial Infarction.Cardiology research and practice · 2021Article
- Expansion of off-site percutaneous coronary intervention centres significantly reduces ambulance driving time to primary PCI in the Netherlands.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Article
- The impact of the Type D Personality pattern on prehospital delay in patients suffering from acute myocardial infarction.Journal of thoracic disease · 2020Article
- Few with ST-segment elevation myocardial infarction are diagnosed within 10 minutes from first medical contact, and women have longer delay times than men.International journal of cardiology. Heart & vasculature · 2020Article
- Influence of Cardiovascular Risk Factors, Comorbidities, Medication Use and Procedural Variables on Remote Ischemic Conditioning Efficacy in Patients with ST-Segment Elevation Myocardial Infarction.International journal of molecular sciences · 2019Review
- The effects of prehospital system delays on the treatment efficacy of STEMI patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly reperfusion in the setting of an ST-elevation myocardial infarction (STEMI) is of utmost importance. However, the effects of early versus late reperfusion in this patient group undergoing primary percutaneous coronary intervention (PCI) have so far been inconsistent in previous studies. The purpose of this study was to evaluate in a nationwide cohort the effects of delay from first medical contact to PCI (first medical contact [FMC]-to-PCI) and secondarily delay from symptom-to-PCI on clinical outcomes. METHODS AND
resultsUsing the national Swedish Coronary Angiography and Angioplasty Register (SCAAR) registry, STEMI patients undergoing primary PCI between the years 2003 and 2008 were screened for. A total of 13 790 patients were included in the FMC-to-PCI analysis and 11 489 patients were included in the symptom-to-PCI analyses. Unadjusted as well as multivariable analyses showed an overall significant association between increasing FMC-to-PCI delay and 1-year mortality. A statistically significant increase in mortality was noted at FMC-to-PCI delays exceeding 1 hour in an incremental fashion. FMC-to-PCI delays in excess of 1 hour were also significantly associated with an increase in severe left ventricular dysfunction at discharge. An overall significant association between increasing symptom-to-PCI delays and 1-year mortality was noted. However, when stratified into time delay cohorts, no symptom-to-PCI delay except for the highest time delay showed a statistically significant association with increased mortality.
conclusionsDelays in FMC-to-PCI were strongly associated with increased mortality already at delays of more than 1 hour, possibly through an increase in severe heart failure. A goal of FMC-to-PCI of less than 1 hour might save patient lives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.