Trends in treatment delays for patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention

BMC Cardiovascular Disorders

Tuomo Nieminen¹  Ilkka Tierala³  Jyrki Lilleberg²  Mika Laine³  Juho Viikilä³  Salla Helve³ 

[1] Department of Internal Medicine, South Karelia Central Hospital, Lappeenranta, Finland;Department of Internal Medicine, Hyvinkää Hospital, Hyvinkää, Finland;Heart and Lung Center, Cardiology, Helsinki University Central Hospital, P.O. Box 340, FI-00029 Helsinki, Finland

关键词: Treatment delays;    ST-segment elevation myocardial infarction;    Prognosis;    Primary percutaneous coronary intervention;   

Others  :  1088457
DOI  :  10.1186/1471-2261-14-115

 received in 2014-03-15, accepted in 2014-08-14,  发布年份 2014

【 摘 要 】

Background

Treatment delay is an important prognostic factor for patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to determine recent trends in these delays and factors associated with longer delays.

Methods

We compared two datasets collected in Helsinki University Central Hospital in 2007–2008 (HUS-STEMI I) and 2011–2012 (HUS-STEMI II), a total of 500 patients treated with primary PCI within 12 hours of the onset of symptoms.

Results

Delays of the emergency medical system (EMS) were longer in HUS-STEMI I than II (medians 81 vs. 67 min, respectively, p < 0.001). Although door-to-balloon times were longer in the later dataset (33 vs. 48 min, p < 0.001) most of the patients (75.3% vs. 62.8%, respectively, p = 0.010) were treated within the recommendation (<60 min) of the European Society of Cardiology (ESC). In HUS-STEMI II, patient arrival at the hospital during off-hours was associated with longer door-to-balloon time (40 and 57.5 min, p = 0.001) and system delay (111 and 127 min, p = 0.009). However, in HUS-STEMI I, arrival time did not impact the delays. Longer system delay was associated with higher mortality rates.

Conclusions

Though the delays inside the hospital have increased they are still mostly within the ESC guidelines. Still, only about half of the patients are treated within a system delay of recommended two hours. Albeit our results are good in comparison with previous studies, further efforts for decreasing the delays particularly within the EMS should be established.

【 授权许可】

   
2014 Helve et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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