ArticleBMC cardiovascular disorders2026
Predictors of a prolonged puncture-wire time in patients with ST-Elevation Myocardial Infarction (STEMI).
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn patients with ST-elevation myocardial infarction (STEMI), rapid reperfusion is essential for optimal outcomes, yet factors influencing intraprocedural delays remain insufficiently investigated.
methodsIn this single-center retrospective study, consecutive STEMI patients undergoing primary percutaneous coronary intervention (PCI) between 2015 and 2024 were analyzed. Prolonged time between vascular puncture and wire passage (puncture-wire time; PWT) was defined as a value in the fourth quartile of the study population (>17.1 minutes). Multivariable logistic regression identified independent predictors and procedural determinants of prolonged PWT.
resultsA total of 1,235 patients (70.7% male, median age 64.5 years [IQR 56.0-75.25]) were included. Radial-to-femoral access crossover (OR 2.539, 95% CI 1.381-4.665, p = 0.003), arterial kinking or severe radial spasm (OR 3.669, 95% CI 1.986-6.778, p < 0.001) and challenging revascularization of the culprit lesion (OR 2.330, 95% CI 1.319-4.116, p = 0.004) were independently associated with prolonged PWT. Direct intervention of the culprit lesion was independently associated with a lower likelihood of prolonged PWT (OR 0.445, 95% CI 0.201 - 0.988, p = 0.047). In contrast, the primary choice of vascular access (radial vs. femoral) was not associated with prolonged PWT (p=0.06).
conclusionWhile some factors are system- or patient-dependent, early recognition of procedural difficulties and individualized access-site decision making may help minimize procedural delays. In selected patients, a primary femoral access route may be considered, and direct intervention of the culprit lesion should be pursued to minimize PWT. CLINICAL TRIAL NUMBER: Not applicable.
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