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February 11, 2018Critical Pathways in Cardiology A Journal of Evidence-Based Medicine

Transfer for primary PCI was not associated with a significant difference in in-hospital major cardiovascular events compared to direct onsite presentation (OR 1.50; 95% CI 0.79-2.84; P=0.21).

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Why the study?

Does transfer from a non-PCI facility compared to direct presentation to a PCI facility affect in-hospital major cardiovascular events in patients with STEMI undergoing primary PCI?

Population

1236 patients with ST-segment elevation myocardial infarction who underwent primary PCI in 2 large regional…

Comparison

Transfer from a non-PCI facility to a primary… vs Direct presentation to the primary PCI center

Design

Cohort

Follow-up

in-hospital

Key result

Transfer for primary PCI was not associated with a significant difference in in-hospital major cardiovascular events compared to direct onsite presentation (OR 1.50; 95% CI 0.79-2.84; P=0.21).

Authors

JMJaya MallidiPVPaul VisintainerIPIndupriya Pallekonda

Discussion

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Member takes

Overview

Transfer not linked to higher events; leaves open transfer safety in STEMI, needing prospective confirmation.

Study Design

Type

Cohort (n=1,236)

Multicenter

Yes

Structured PICO

Does transfer from a non-PCI facility compared to direct presentation to a PCI facility affect in-hospital major cardiovascular events in patients with STEMI undergoing primary PCI?

P
Population
1,236 patients presenting with STEMI who underwent primary PCI at 2 regional centers in Massachusetts between 2005 and 2009.
E
Exposure
Transfer from a non-PCI facility to a primary PCI facility
C
Comparator
Direct presentation to the primary PCI center (onsite patients)
O
Outcome
Composite of in-hospital major cardiovascular events (death, myocardial infarction, and stroke)composite

Main Result

Odds Ratio: 1.5 (95% CI 0.79–2.84)

Absolute Event Rate: 5.3% vs 3.8%

p-value: p=0.21

Transferring STEMI patients from non-PCI to PCI facilities within an integrated regional program results in equivalent in-hospital clinical outcomes compared to direct presentation, despite longer door-to-balloon times.

Cite This Study

Mallidi et al. (2018) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,236). Transfer from a non-PCI facility vs. Direct onsite presentation to the primary PCI center was evaluated on Composite of in-hospital major cardiovascular events (death, myocardial infarction, and stroke) (OR 1.50, 95% CI 0.79-2.84, p=0.21). Transfer for primary PCI was not associated with a significant difference in in-hospital major cardiovascular events compared to direct onsite presentation (OR 1.50; 95% CI 0.79-2.84; P=0.21).

synapsesocial.com/papers/6a97fec6b14ffd067bd7d25bhttps://doi.org/10.1097/hpc.0000000000000117
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Also Consider

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

  1. 1The impact of transferring patients with ST-segment elevation myocardial infarction to percutaneous coronary intervention-capable hospitals on clinical outcomes2016 · 14 citations
  2. 2Prehospital Transfer Pathway and Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention2015 · 21 citations
  3. 3Times to Treatment in Transfer Patients Undergoing Primary Percutaneous Coronary Intervention in the United States2005 · 497 citations
  4. 4Inter-hospital transfers and door-to-balloon times for STEMI: a single centre cohort study.2020 · 6 citations
  5. 5Nationwide Analysis of Patients With ST-Segment–Elevation Myocardial Infarction Transferred for Primary Percutaneous Intervention2015 · 60 citations