AIMS: This study sought to evaluate the impact of a direct transfer strategy on treatment times and prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI). METHODS AND RESULTS: We conducted a cohort study of 1,194 patients who underwent PPCI in our centre between May 2005 and December 2008. We studied the role of direct transfer on time to treatment and door-to-balloon delays and its effect on 30-day mortality adjusted by risk profile on admission. During this period, 255 patients (21%) experienced direct transfer (DT) from the field to the catheterisation laboratory. Patients referred directly for PPCI experienced lower median door-to-balloon delay (102 minutes vs. 125 minutes, p<0.0001) and lower time to treatment (median 189 minutes vs. 259 minutes, p<0.0001) when compared with those referred from emergency departments (ED). These differences were consistent, with respect to door-to-balloon delay and time to treatment interval, in patients from our catchment area: median 88 vs. 98 minutes, (p=0.003) and 174 vs. 219 minutes (p<0.0001) respectively, and from long-distance transfer: 110 vs. 169 minutes (p<0.0001) and 197 minutes vs. 342 minutes (p<0.0001) respectively. Patients in the DT group experienced lower 30-day mortality than patients transferred from the ED (2.7% vs. 6.8%, p=0.017). In a multivariable analysis, DT strategy was independently associated with better short-term prognosis (OR 0.33, CI95% 0.12 - 0.92). CONCLUSIONS: Direct transfer reduces time delays and improves prognosis of patients with STEMI undergoing PPCI.
AIMS: This study sought to evaluate the impact of a direct transfer strategy on treatment times and prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI). METHODS AND RESULTS: We conducted a cohort study of 1,194 patients who underwent PPCI in our centre between May 2005 and December 2008. We studied the role of direct transfer on time to treatment and door-to-balloon delays and its effect on 30-day mortality adjusted by risk profile on admission. During this period, 255 patients (21%) experienced direct transfer (DT) from the field to the catheterisation laboratory. Patients referred directly for PPCI experienced lower median door-to-balloon delay (102 minutes vs. 125 minutes, p<0.0001) and lower time to treatment (median 189 minutes vs. 259 minutes, p<0.0001) when compared with those referred from emergency departments (ED). These differences were consistent, with respect to door-to-balloon delay and time to treatment interval, in patients from our catchment area: median 88 vs. 98 minutes, (p=0.003) and 174 vs. 219 minutes (p<0.0001) respectively, and from long-distance transfer: 110 vs. 169 minutes (p<0.0001) and 197 minutes vs. 342 minutes (p<0.0001) respectively. Patients in the DT group experienced lower 30-day mortality than patients transferred from the ED (2.7% vs. 6.8%, p=0.017). In a multivariable analysis, DT strategy was independently associated with better short-term prognosis (OR 0.33, CI95% 0.12 - 0.92). CONCLUSIONS: Direct transfer reduces time delays and improves prognosis of patients with STEMI undergoing PPCI.
Authors: Rodrigo Estévez-Loureiro; Angela López-Sainz; Armando Pérez de Prado; Carlos Cuellas; Ramón Calviño Santos; Norberto Alonso-Orcajo; Jorge Salgado Fernández; Jose Manuel Vázquez-Rodríguez; Maria López-Benito; Felipe Fernández-Vázquez Journal: World J Cardiol Date: 2014-06-26
Authors: X Flores-Ríos; D Couto-Mallón; J Rodríguez-Garrido; M García-Guimaraes; P Gargallo-Fernández; P Piñón-Esteban; G Aldama-López; J Salgado-Fernández; R Calviño-Santos; N Vázquez-González; A Castro-Beiras Journal: Eur Heart J Acute Cardiovasc Care Date: 2013-03
Authors: S Postma; J H E Dambrink; M J de Boer; A T M Gosselink; J P Ottervanger; P C Koopmans; J M Ten Berg; H Suryapranata; A W J van 't Hof Journal: Neth Heart J Date: 2014-11 Impact factor: 2.380