Key result
Longer chest pain center time indicators, such as door-to-balloon time, were associated with increased mortality risk in STEMI patients with Killip Class ≥2 (35 total deaths at 17 months).
Why the study?
Despite the crucial role of chest pain centers, China's mortality rate for STEMI has remained stagnant, prompting an evaluation of quality control indicators during the COVID-19 pandemic.
Do chest pain center quality control indicators affect mortality risk in STEMI patients undergoing primary PCI?
Cohort (n=664)
Do chest pain center quality control indicators affect mortality risk in STEMI patients undergoing primary PCI?
Chest pain center quality control metrics, particularly time-to-treatment indicators, significantly impact mortality in STEMI patients undergoing primary PCI, with effects varying by Killip class.
CPC quality indicators may associate with STEMI mortality during COVID-19; leaves open whether optimization improves outcomes beyond this observational cohort.
Background Despite the crucial role of Chest pain centers (CPCs) in acute myocardial infarction (AMI) management, China's mortality rate for ST-segment elevation myocardial infarction (STEMI) has remained stagnant. This study evaluates the influence of CPC quality control indicators on mortality risk in STEMI patients receiving primary percutaneous coronary intervention (PPCI) during the COVID-19 pandemic. Methods A cohort of 664 consecutive STEMI patients undergoing PPCI from 2020 to 2022 was analyzed using Cox proportional hazards regression models. The cohort was stratified by Killip classification at admission (Class 1: n = 402, Class ≥2: n = 262). Results At a median follow-up of 17 months, 35 deaths were recorded. In Class ≥2, longer door-to-balloon (D-to-B) time, PCI informed consent time, catheterization laboratory activation time, and diagnosis-to-loading dose dual antiplatelet therapy (DAPT) time were associated with increased mortality risk. In Class 1, consultation time (notice to arrival) under 10 min reduced death risk. In Class ≥2, PCI informed consent time under 20 min decreased mortality risk. Conclusion CPC quality control metrics affect STEMI mortality based on Killip class. Key factors include time indicators and standardization of CPC management. The study provides guidance for quality care during COVID-19.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2024) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=664). Chest pain center quality control indicators (time delays) vs. Shorter time intervals was evaluated on Mortality. Longer chest pain center time indicators, such as door-to-balloon time, were associated with increased mortality risk in STEMI patients with Killip Class ≥2 (35 total deaths at 17 months).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: