BACKGROUND: In an attempt to improve the treatment of patients with acute coronary syndromes (ACS), a network of certified chest pain units (CPUs) has been recently established in Germany. METHODS: Data from patients admitted between December 2008 and September 2011 for ACS in 40 certified CPUs participating in the registry were prospectively collected. RESULTS: A total of 5,457 patients was admitted for ACS; 798 patients (14.6 %) were diagnosed with an ST-elevation myocardial infarction (STEMI), 2,244 (41.1 %) with a non-ST-elevation myocardial infarction (NSTEMI), and 2,415 (44.3 %) with unstable angina. The mean time to first medical contact was 2:08 h for STEMI patients. A pre-hospital ECG was available in 23.8 % of all ACS patients. Importantly, evidence of ST-segment elevation was present in 79.7 % of the STEMI patients already in this pre-hospital ECG. As many as 76.6 % of the patients, independently of their symptoms and final diagnosis, received an ECG within 10 min of reaching the CPU. 98.2 % of STEMI patients underwent invasive diagnostics, with an in-hospital delay as little as 31 (11-75) min. CONCLUSION: The establishment of a nation-wide network of certified CPUs optimizes the medical treatment of patients with ACS while providing an ideal infrastructure to evaluate and improve, both on a nation-wide and a single center scale, the adherence to guidelines. The median delay between symptom onset and first medical contact remains high. Although performed relatively rarely, a pre-hospital ECG facilitates earlier diagnosis of a STEMI in a large majority of patients. The introduction of CPUs minimizes in-hospital delays and exploits the benefit of invasive diagnostics and treatment.
BACKGROUND: In an attempt to improve the treatment of patients with acute coronary syndromes (ACS), a network of certified chest pain units (CPUs) has been recently established in Germany. METHODS: Data from patients admitted between December 2008 and September 2011 for ACS in 40 certified CPUs participating in the registry were prospectively collected. RESULTS: A total of 5,457 patients was admitted for ACS; 798 patients (14.6 %) were diagnosed with an ST-elevation myocardial infarction (STEMI), 2,244 (41.1 %) with a non-ST-elevation myocardial infarction (NSTEMI), and 2,415 (44.3 %) with unstable angina. The mean time to first medical contact was 2:08 h for STEMI patients. A pre-hospital ECG was available in 23.8 % of all ACS patients. Importantly, evidence of ST-segment elevation was present in 79.7 % of the STEMI patients already in this pre-hospital ECG. As many as 76.6 % of the patients, independently of their symptoms and final diagnosis, received an ECG within 10 min of reaching the CPU. 98.2 % of STEMI patients underwent invasive diagnostics, with an in-hospital delay as little as 31 (11-75) min. CONCLUSION: The establishment of a nation-wide network of certified CPUs optimizes the medical treatment of patients with ACS while providing an ideal infrastructure to evaluate and improve, both on a nation-wide and a single center scale, the adherence to guidelines. The median delay between symptom onset and first medical contact remains high. Although performed relatively rarely, a pre-hospital ECG facilitates earlier diagnosis of a STEMI in a large majority of patients. The introduction of CPUs minimizes in-hospital delays and exploits the benefit of invasive diagnostics and treatment.
Authors: B Vogel; S Hahne; I Kozanli; K Kalla; R Jarai; M Freynhofer; P Smetana; M Nürnberg; A Geppert; G Unger; K Huber Journal: Int J Cardiol Date: 2011-03-29 Impact factor: 4.164
Authors: Ralf Birkemeyer; Andreas Rillig; Annette Koch; Tomislav Miljak; Markus Kunze; Udo Meyerfeldt; Wolfgang Steffen; Martin Soballa; Carsten Ranke; Roland Prassler; Albert Benzing; Werner Jung Journal: Clin Res Cardiol Date: 2010-07-06 Impact factor: 5.460
Authors: Deborah B Diercks; W Frank Peacock; Brian C Hiestand; Anita Y Chen; Charles V Pollack; J Douglas Kirk; Sidney C Smith; W Brian Gibler; E Magnus Ohman; Andra L Blomkalns; L Kristin Newby; Judith S Hochman; Eric D Peterson; Matthew T Roe Journal: Am J Cardiol Date: 2005-12-13 Impact factor: 2.778
Authors: P J Kudenchuk; C Maynard; L A Cobb; M Wirkus; J S Martin; J W Kennedy; W D Weaver Journal: J Am Coll Cardiol Date: 1998-07 Impact factor: 24.094
Authors: Judith M Poldervaart; A Jacob Six; Barbra E Backus; Hector W L de Beaufort; Maarten-Jan M Cramer; Rolf F Veldkamp; E Gijs Mast; Eugène M Buijs; Wouter J Tietge; Björn E Groenemeijer; Luc Cozijnsen; Alexander J Wardeh; Hester M den Ruiter; Pieter A Doevendans Journal: Clin Res Cardiol Date: 2013-01-03 Impact factor: 5.460
Authors: S Mijatovic; D Maksimovic-Ivanic; J Radovic; Dj Miljkovic; Lj Harhaji; O Vuckovic; S Stosic-Grujicic; M Mostarica Stojkovic; V Trajkovic Journal: Cell Mol Life Sci Date: 2005-03 Impact factor: 9.261
Authors: F Breuckmann; F Remberg; D Böse; M Lichtenberg; P Kümpers; H Pavenstädt; J Waltenberger; D Fischer Journal: Herz Date: 2015-09-25 Impact factor: 1.443