Adam W Hutchison1, Yuvaraj Malaiapan, James D Cameron, Ian T Meredith. 1. Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Department of Medicine (MMC), Monash University, Melbourne, Australia. Electronic address: adamhutchison@hotmail.com.
Abstract
BACKGROUND: Pre-hospital ECG is one strategy to improve door to balloon times (D2BT), however its long term effectiveness to sustain reductions in D2BT has not been evaluated. METHODS: From 2007 to 2011 we conducted a prospective interventional study involving 1000 patients undergoing primary PCI (PPCI) at a single tertiary referral institution to determine the long term impact of pre-hospital 12 lead ECG on D2BT. RESULTS: The median D2BT of patients (n=414) who underwent PPCI following field 12-lead ECG was 54 min [IQR: 37-71 min] compared to the median time of a contemporary group (n=586) undergoing PPCI during the same period but not presenting via field triage of 100 min [74-134] (p<0.001). The proportion of patients who achieved a D2BT of ≤90 min in the pre-hospital ECG group was greater than that in the contemporary group (90% vs 42%, p<0.001). A comparison of the first 250 patients compared to subsequent 250 patient blocks showed no change in D2BT. CONCLUSIONS: Introduction of pre-hospital ECG in the triage of STEMI resulted in a sustained reduction in D2BT.
BACKGROUND: Pre-hospital ECG is one strategy to improve door to balloon times (D2BT), however its long term effectiveness to sustain reductions in D2BT has not been evaluated. METHODS: From 2007 to 2011 we conducted a prospective interventional study involving 1000 patients undergoing primary PCI (PPCI) at a single tertiary referral institution to determine the long term impact of pre-hospital 12 lead ECG on D2BT. RESULTS: The median D2BT of patients (n=414) who underwent PPCI following field 12-lead ECG was 54 min [IQR: 37-71 min] compared to the median time of a contemporary group (n=586) undergoing PPCI during the same period but not presenting via field triage of 100 min [74-134] (p<0.001). The proportion of patients who achieved a D2BT of ≤90 min in the pre-hospital ECG group was greater than that in the contemporary group (90% vs 42%, p<0.001). A comparison of the first 250 patients compared to subsequent 250 patient blocks showed no change in D2BT. CONCLUSIONS: Introduction of pre-hospital ECG in the triage of STEMI resulted in a sustained reduction in D2BT.