For nearly 50 years, physicians have recognized the close link between ischemic time and myocardial infarct size in patients presenting with ST-segment elevation myocardial infarction (STEMI). Beginning in the 1970s, a series of animal experiments demonstrated the time-dependent nature of this association when investigators temporarily occluded the coronary arteries of dogs and pigs and established the potential for myocardial salvage with rapid coronary reperfusion. These principles were subsequently translated to humans, first with the advent of thrombolytic therapy and then coronary angioplasty. As these therapies became more prevalent, multiple studies demonstrated improved outcomes for STEMI patients who received prompt reperfusion, laying the foundation for the “time is muscle” mantra.
Source: JAMA Online First