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

BMC Cardiovascular Disorders

Research Article

Jyrki Lilleberg¹  Ilkka Tierala²  Salla Helve²  Juho Viikilä²  Mika Laine²  Tuomo Nieminen³ 

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

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

DOI  :  10.1186/1471-2261-14-115

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

来源: Springer

【 摘 要 】

BackgroundTreatment 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.MethodsWe 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.ResultsDelays 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.ConclusionsThough 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】

Unknown   
© Helve et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.