Medical History of Coronary Artery Disease and Time to Electrocardiogram in the Emergency Department: A Real-Life, Single-Center, Retrospective Analysis

Background: Timely acquisition of 12-lead Electrocardiogram (ECG) in the emergency department (ED) is crucial and recommended by current guidelines. Objectives: To evaluate the association of medical history of coronary artery disease (hCAD) on door-to-ECG time in the ED. Methods: In this single center, retrospective cohort study, patients admitted to ED for cardiac evaluation between were grouped according to hCAD, and no hCAD. The primary outcome was door-to-ECG time. A multivariate analysis adjusted for the cofounders sex, age, type of referral and shift was performed to evaluate the association of hCAD with door-to-ECG. Results: 1,101 patients were included in this analysis. 362 patients (33%) had hCAD. Patients with hCAD had shorter door-to-ECG time (20 min. [Inter Quartile Range [IQR] 13 – 30] vs. 22 min. [IQR 14 – 37]; p<0.001) when compared to patients with no hCAD. In a multivariable regression analysis hCAD was significantly associated with a shorter door-to-ECG time (- 3 min. [p=0.007; 95% confidence Interval [CI] -5.16 ­– -0.84 min.]). Conclusion: In this single center registry, hCAD was associated with shorter door-to-ECG time. In patients presenting in ED for cardiac evaluation, timely ECG diagnostic should be facilitated irrespective of hCAD.