BACKGROUND: Conflicting datas exist regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) when the intervention is performed during night hours. METHODS AND RESULTS: 2,644 consecutive patients with STEMI (mean age 56.7 +/- 11.9, years, 2,188 male) undergoing primary PCI between October 2003 and March 2008 were retrospectively enrolled into this study (single high-volume center: >3,000 PCIs/year). Day time was defined according to intervention between 08:00 am and 06:00 pm and night as intervention time between 06:00 pm and 08:00 am. 1,141 patients (43.2%) were treated during the day and 1,503 (56.8%) at night. The baseline characteristics of both groups were similar except for more frequent hypertension (42.6 vs. 36.5%; P = 0.002), women (19.7 vs. 15.4%; P = 0.003), and old (> or =75 y) patients (9.6 vs. 7.4; P = 0.046) in the day time group. Compared with those treated during night time, day time patients had longer angina-reperfusion times (mean, 205 vs. 188 minutes, P = 0.016). Door-to-balloon times were similar (P = 0.87), and less than 90 minutes in both groups. There were no differences concerning clinical events and PCI success between the two groups. Hospital mortality was 6.1% during the day and 5.2% during the night (OR 0.98, 95% CI 0.7-1.36; P = 0.89). The median follow-up time was 21 months. The Kaplan-Meier survival plot for long-term cardiovascular death was not different for both groups (P = 0.78). In-hospital and long-term cardiovascular mortality was also similar in shock and nonshock subgroups. CONCLUSIONS: Primary PCI can be performed safely during the night at a high-volume PCI center with suitable and effective organization of cardiology department and catheterisation laboratory with 24 hours per day, 7 days per week onsite staffing. Copyright 2009 Wiley-Liss, Inc.
BACKGROUND: Conflicting datas exist regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) when the intervention is performed during night hours. METHODS AND RESULTS: 2,644 consecutive patients with STEMI (mean age 56.7 +/- 11.9, years, 2,188 male) undergoing primary PCI between October 2003 and March 2008 were retrospectively enrolled into this study (single high-volume center: >3,000 PCIs/year). Day time was defined according to intervention between 08:00 am and 06:00 pm and night as intervention time between 06:00 pm and 08:00 am. 1,141 patients (43.2%) were treated during the day and 1,503 (56.8%) at night. The baseline characteristics of both groups were similar except for more frequent hypertension (42.6 vs. 36.5%; P = 0.002), women (19.7 vs. 15.4%; P = 0.003), and old (> or =75 y) patients (9.6 vs. 7.4; P = 0.046) in the day time group. Compared with those treated during night time, day time patients had longer angina-reperfusion times (mean, 205 vs. 188 minutes, P = 0.016). Door-to-balloon times were similar (P = 0.87), and less than 90 minutes in both groups. There were no differences concerning clinical events and PCI success between the two groups. Hospital mortality was 6.1% during the day and 5.2% during the night (OR 0.98, 95% CI 0.7-1.36; P = 0.89). The median follow-up time was 21 months. The Kaplan-Meier survival plot for long-term cardiovascular death was not different for both groups (P = 0.78). In-hospital and long-term cardiovascular mortality was also similar in shock and nonshock subgroups. CONCLUSIONS: Primary PCI can be performed safely during the night at a high-volume PCI center with suitable and effective organization of cardiology department and catheterisation laboratory with 24 hours per day, 7 days per week onsite staffing. Copyright 2009 Wiley-Liss, Inc.
Authors: Raphael L C Araujo; Ami M Karkar; Peter J Allen; Mithat Gönen; Joanne F Chou; Murray F Brennan; Leslie H Blumgart; Michael I D'Angelica; Ronald P DeMatteo; Daniel G Coit; Yuman Fong; William R Jarnagin Journal: HPB (Oxford) Date: 2013-04-18 Impact factor: 3.647
Authors: Atsushi Sorita; Adil Ahmed; Stephanie R Starr; Kristine M Thompson; Darcy A Reed; Larry Prokop; Nilay D Shah; M Hassan Murad; Henry H Ting Journal: BMJ Date: 2014-01-21