The Impact of a New STEMI Hotline on Cardiovascular Outcomes in STEMI Patients Undergoing Primary PCI: A National Cohort Study

Introduction: ST-Elevation myocardial infarction (STEMI) remains a common and challenging clinical condition with a high risk of mortality. STEMI complications are related directly to prolonged ischemia time. Mohamad Bin Khalifa Cardiac Centre (MKCC) established a national STEMI Hotline program on January 2022, to facilitate early detection and transfer of STEMI cases in the country to a dedicated tertiary cardiac center capable of performing primary PCI. Methods: This is an observational cohort study conducted on patients who presented to MKCC for primary PCI between August 2021 to February 2022. Patients who underwent primary PCI through referral from the newly developed STEMI hotline were compared to patients who presented through the traditional referral pathway. The primary outcome was the development of in-hospital cardiovascular complications-requirement of inotropes, mechanical support, mechanical ventilation, emergency surgery due to mechanical complications, cardiac arrest, or death. Multivariate logistic regression models were used to compare the outcomes and to estimate the effect of the hotline on patient outcomes. Results: A total of 197 patients were included, out of which 96 were referred through the STEMI Hotline. The primary outcome occurred in 11.5% of patients in the hotline group as compared to 22.8% of patients in the traditional pathway. Upon adjusting for confounders in the multivariate regression model, the use of the hotline had an odds ratio of 0.39 (95% CI: 0.17-0.9; p = 0.03) for the primary outcome. Conclusion: Our results indicate that the use of the STEMI Hotline decreased risk of in-hospital cardiovascular complication in patients with STEMI.