Every minute counts: in-hospital changes of left ventricular regional and global function in patients with ST-segment elevation myocardial infarction

Aims The aim of our study was to assess the effects of an early percutaneous coronary intervention on changes of in-hospital left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) in patients with ST-segment elevation myocardial infarction. Methods The study population consisted of 324 consecutive patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention, divided into two groups, according to the first medical contact (FMC)-to-reperfusion time, respectively, 90 min or less (n = 173) and more than 90 min (n = 151). Moreover, we performed a sub-analysis in the group of patients who showed at discharge an improvement in the LVEF of at least 10%. Results In both groups at baseline, patients suffered from a moderately reduced LVEF (40.88 +/- 8.38% in <= 90 min group vs. 40.70 +/- 8.98% in >90 min group; P = 0.858). A WMSI of more than 1 was recorded uniformly: 1.71 +/- 0.37 in patients with FMC-to-reperfusion 90 min or less and 1.72 +/- 0.38 in patients more than 90 min (P = 0.810). At the time of discharge, a significant improvement in LVEF (43.82 +/- 8.38%, P = 0.001) and WMSI (1.60 +/- 0.41, P = 0.009) exclusively emerged in the 90 min or less group. Furthermore, we identified 105 patients who experienced an improvement in the LVEF of at least 10% compared with baseline values. In these patients FMC-to-reperfusion and total ischemic time resulted as significantly shorter, when compared with patients with LVEF improvement of less than 10%. Conclusion Our study confirms and reinforces the concept that reducing the duration of the time between FMC and reperfusion, as well as the total ischemic time influences a positive recovery of left ventricular global and regional function during in-hospital stay.