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December 1, 2009Circulation Cardiovascular Interventions

Prehospital 12-Lead ECG to Triage ST-Elevation Myocardial Infarction and Emergency Department Activation of the Infarct Team Significantly Improves Door-to-Balloon Times

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Why the study?

Does prehospital 12-lead ECG triage and emergency department activation of the infarct team reduce door-to-balloon time in patients undergoing PPCI for STEMI?

Population

349 patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction at…

Comparison

Prehospital 12-lead ECG triage and emergency… vs Contemporary group undergoing PPCI without field…

Design

Cohort

Authors

AHAdam HutchisonBarwon HealthYMYuvaraj MalaiapanAustralian Centre for Heart HealthIJI. C. JarvieYork University

Discussion

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Overview

Prehospital triage associated with shorter D2BT; extends observational data but leaves open randomized confirmation before practice change.

Structured PICO

Does prehospital 12-lead ECG triage and emergency department activation of the infarct team reduce door-to-balloon time in patients undergoing PPCI for STEMI?

P
Population
349 patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI) at a single tertiary referral institution.
I
Intervention
Prehospital 12-lead ECG triage and emergency department activation of the infarct team (n=107)
C
Comparator
Contemporary group undergoing PPCI without field triage (n=122) and a historical consecutive group before project initiation (n=120)
O
Outcome
Door-to-balloon time (D2BT)surrogate

Prehospital 12-lead ECG triage with emergency department activation of the infarct team significantly reduces door-to-balloon times and increases the proportion of STEMI patients meeting the ≤90 minute guideline target.

Cite This Study

Hutchison et al. (2009) studied this question.

synapsesocial.com/papers/6a87db7ff762332bf8fe86aehttps://doi.org/10.1161/circinterventions.109.892372
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs.1977 · 1,940 citations
  2. 2Strategies for Reducing the Door-to-Balloon Time in Acute Myocardial Infarction2006 · 846 citations
  3. 3Door-to-Balloon Time With Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Impacts Late Cardiac Mortality in High-Risk Patients and Patients Presenting Early After the Onset of Symptoms2006 · 238 citations
  4. 4Field triage to primary angioplasty combined with emergency department bypass reduces treatment delays and is associated with improved outcome2007 · 136 citations
  5. 5Times to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States2005 · 497 citations