Why the study?
The ambulance system is vital for early STEMI management, but the impact of transport mode on reperfusion therapy and mortality required examination across long-term temporal trends.
Does transport method improve reperfusion therapy and mortality in patients with ST-segment-elevation myocardial infarction?
Does transport method improve reperfusion therapy and mortality in patients with ST-segment-elevation myocardial infarction?
Improved MACE and mortality rates in STEMI patients over time are primarily attributed to enhanced in-hospital and postdischarge care rather than transport improvements.
Answers are grounded in this paper and cite their sources.
Supports prioritizing in-hospital and postdischarge care optimization in STEMI; observational data leave open incremental benefit from transport improvements.
BACKGROUND: The ambulance system is vital for the early management of patients with ST-segment-elevation myocardial infarction, reducing delays in diagnosis and treatment. This study examined the impact of transport mode on reperfusion therapy and mortality among patients with ST-segment-elevation myocardial infarction from 2000 to 2021. METHODS: Data from the ACSIS (Acute Coronary Syndrome Israeli Survey) registry 2000 to 2021 were analyzed. Three transport methods of patients with ST-segment-elevation myocardial infarction were evaluated. The impact on patient outcomes was assessed. Temporal trends from early (2000-2010) and late (2013-2021) periods were compared. CONCLUSIONS: Improved major adverse cardiovascular event and mortality rates are attributed to enhanced in-hospital and postdischarge care, including primary percutaneous coronary intervention and guideline-directed medical therapy rather than transport improvements, although these contribute to more stable arrival conditions.
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Rotholz et al. (2025) studied this question.
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