Evidence mapPaperPMID 41440853Full record

ReviewJournal of cardiovascular development and disease2025

The Irreversible March of Time: Ischemic Delay and Impact on Outcomes in ST-Segment Elevation Myocardial Infarction.

Artur Dziewierz, Barbara Zdzierak, Wojciech Wańha, Giuseppe De Luca, Tomasz Rakowski

Abstract readReview
In one paragraph

Review in Journal of cardiovascular development and disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Artur Dziewierz2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland.ORCID 0000-0002-2100-5076
Barbara Zdzierak2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland.ORCID 0000-0001-9331-978X
Wojciech WańhaDepartment of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-635 Katowice, Poland.ORCID 0000-0003-1220-9496
Giuseppe De LucaDivision of Cardiology, AOU Policlinico G Martino, University of Messina, 98124 Messina, Italy.
Tomasz Rakowski2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland.ORCID 0000-0001-6478-6186

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

ST-segment elevation myocardial infarction (STEMI) represents a time-critical medical emergency where complete coronary artery occlusion initiates progressive myocardial necrosis. The fundamental principle of modern STEMI care-"Time is Muscle"-establishes that ischemic duration directly determines infarct size and clinical outcomes. Each minute of delay correlates with increased mortality, larger infarcts, and a higher risk of heart failure development. Total ischemic time encompasses both patient-mediated delays (often the largest component) and system-related delays, each influenced by distinct factors requiring targeted interventions. This comprehensive review analyzes the components of total ischemic time, quantifies the clinical consequences of delay, and evaluates evidence-based mitigation strategies. We examine the evolution from fibrinolysis to primary percutaneous coronary intervention and the resulting logistical challenges. System-level interventions-including public awareness campaigns, regionalized STEMI networks, pre-hospital ECG acquisition, and standardized hospital protocols-have dramatically reduced treatment times. However, persistent disparities based on geography, presentation timing, sex, race, and age remain problematic. Emerging technologies, particularly artificial intelligence for ECG interpretation, offer promise for further time reduction.

Indexed as

door-to-balloon timeischemic timeocclusion myocardial infarctionreperfusion delaySTEMI networksST-segment elevation myocardial infarction

Identifiers

PMID41440853
PMCPMC12733498

What Socratic holds

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Registered trials

None linked

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 Socratic graph.