Key result
Referred patients reach primary PCI fastest at ~31 minutes versus ambulance and outpatient arrivals.
Why the study?
Determining local times to reach primary PCI in STEMI patients admitted to the emergency department is important for assessing compliance with guidelines and their effects on morbidity and mortality.
Does the mode of admission affect the time to reach primary PCI and subsequent mortality or morbidity in patients with STEMI?
Cohort (n=233)
No
Does the mode of admission affect the time to reach primary PCI and subsequent mortality or morbidity in patients with STEMI?
p-value: p=<0.001
Time to reach primary PCI in STEMI patients varies significantly by mode of admission but did not significantly impact mortality or morbidity in this single-center cohort.
Aim: There are strong recommendations regarding the duration of the primary percutaneous coronary intervention (PCI) in STsegment elevation myocardial infarction (STEMI) patients admitted to the emergency department (ED). Determining these periods in local sources is important in comparing their compliance with current diagnosis and treatment guidelines and their effects on morbidity-mortality.Material and Method: Patients with STEMI who applied to the ED of a tertiary education and research hospital between 01.10.2017 and 01.10.2019,accompanied by the prehospital health system or outpatient, were included in this single-center retrospective study.The time to reach PCI and the effects on mortality and morbidity were evaluated in patients diagnosed with STEMI in the ED or referred from an external center with the diagnosis of STEMI.Results: 233 patients were included in the study.The mean age of the patients in the study was 61.84±11.70,and 19.31% were female.The time to reach PCI was 55.55±45.08minutes in patients admitted directly to our hospital by ambulance, 68.27±57.15minutes in outpatients, and 30.54±27.39 minutes in patients referred from another hospital, which was significantly different (p<0.001).There was no significant difference between patients with and without complications in terms of arrival time to PCI (medians were 37 vs 42, p=0.054).There was no significant difference between the cases with a mortal course and the cases without mortality in terms of the time of arrival to PCI (medians were 37 vs 43, p=0.914).Conclusion: Although the times seem to be compatible with current guidelines, the situations that increase the average need to be revealed.In particular, it is necessary to take measures to limit the time to reach PCI for outpatients.In this study, although the time to reach PCI complies with current guidelines, it shows that other regulations are needed to reduce STEMI-related mortality.
No takes yet. Share an insight, caveat, or question.
Erkek et al. (2021) conducted a cohort in ST-Segment Elevation Myocardial Infarction (STEMI) (n=233). Mode of hospital admission (ambulance, outpatient, or referral) vs. Between-group comparison was evaluated on Time to reach primary percutaneous coronary intervention (PCI) (p=<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: