From ST-segment Myocardial Infarction Networks to Stroke Networks – When Time Is Tissue

Background Cardiovascular diseases (CVDs) represent a leading cause of global mortality, with acute myocardial infarction (AMI) a significant contributor. Although advancements in treatment and preventive strategies have improved outcomes in many regions, disparities persist, particularly in Eastern European countries like Romania, where CVD-related mortality remains disproportionately high. This study investigated temporal trends in AMI management and stroke incidence within a Romanian regional AMI network over three consecutive first quarters (Q1 2022–2024). Materials and methods A total of 722 patients were included. Patients were classified as STEMI or NSTEMI according to ESC guidelines. Data were collected on clinical management, including pPCI timing, coronary angiography, pharmacological treatments, radial access, LDL-cholesterol evaluation, and stroke history or in-hospital stroke events. Results Timely primary percutaneous coronary intervention (pPCI) for STEMI patients improved significantly, both in overall use and in administration within 120 minutes of symptom onset. Radial access rates remained consistently high. Significant gains were noted in LDL-cholesterol evaluation and, among patients with LVEF <40%, in ACE inhibitor/ARB and beta-blocker prescriptions. Although timely coronary angiography increased in NSTEMI patients, this change was not statistically significant. Stroke history and in-hospital occurrence varied across study periods. Conclusions The study's findings highlight advancements in AMI care while emphasizing the continued need to address disparities and the crucial role of timely intervention, reflecting the ‘time is tissue’ principle for optimal patient outcomes.