May 2022 Br J Cardiol 2022;29:60–3 doi:10.5837/bjc.2022.017
Cormac T O’Connor, Abdallah Ibrahim, Anthony Buckley, Caoimhe Maguire, Rajesh Kumar, Jatinder Kumar, Samer Arnous, Thomas J Kiernan
Abstract
Introduction
Despite primary percutaneous coronary intervention (pPCI) programmes,1-3 ST-elevation myocardial infarction (STEMI) is associated with significant morbidity and mortality.2,3 Total ischaemic time predicts mortality in STEMI,4,5 and was adopted by the European Society of Cardiology (ESC) in the most recent STEMI guidelines.3 This time-period starts at the onset of chest pain and ends at wire cross, including onset-to-door and door-to-balloon time, and outcomes worsen beyond 120 minutes.6 The ESC guideline advises optimal time cut-offs for each step. This document re-highlights ‘time is muscle’, first described by Braunwald 50
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