F Breuckmann1, F Remberg2, D Böse2, J Waltenberger3, D Fischer3, T Rassaf4. 1. Klinik für Kardiologie, Klinikum Arnsberg, Stolte Ley 5, 59759, Arnsberg, Germany. f.breuckmann@klinikum-arnsberg.de. 2. Klinik für Kardiologie, Klinikum Arnsberg, Stolte Ley 5, 59759, Arnsberg, Germany. 3. Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany. 4. West German Heart and Vascular Center Essen, Department of Cardiology, University Duisburg-Essen, Essen, Germany.
Abstract
AIM: The aim of this study was to analyze differences in the timing of invasive management of patients with high-risk acute coronary syndrome without persistent ST-segment elevation (hr-NSTE-ACS) or myocardial infarction without persistent ST-segment elevation (NSTEMI) between on- and off-hours in a German chest pain unit (CPU). PATIENTS AND METHODS: We retrospectively enrolled 160 NSTEMI patients in the study, who were admitted to two German CPUs in 2013. Patients presenting on weekdays between 8 a.m. and 6 p.m. were compared with patients presenting during off-hours. Data analysis included time intervals from admission to invasive management (goals: for hr-NSTE-ACS, <2 h; for NSTEMI, <24 h) and the resulting guideline adherence. RESULTS: Guideline-adherent timing of an invasive strategy did not differ significantly between the on-hour (6.5 h [3.0-22.0 h], 79.9 %) and off-hour groups (10.5 h [2.0-20.0 h], 75.3 %; p = 0.94), without additional significant differences between admissions during off-hours Monday to Thursday and weekends (10.0 h [2.0-19.0 h], 75.6 % vs. 7.5 h [2.0-20.0 h], 76.2 %; p = 0.96). CONCLUSION: Our exemplary experience in two different German CPUs demonstrates adequate timing of coronary catheterization in over 75 % of cases, irrespective of admission during on- or off-hours. Nationwide validation of our findings by the German CPU registry is mandatory.
AIM: The aim of this study was to analyze differences in the timing of invasive management of patients with high-risk acute coronary syndrome without persistent ST-segment elevation (hr-NSTE-ACS) or myocardial infarction without persistent ST-segment elevation (NSTEMI) between on- and off-hours in a German chest pain unit (CPU). PATIENTS AND METHODS: We retrospectively enrolled 160 NSTEMI patients in the study, who were admitted to two German CPUs in 2013. Patients presenting on weekdays between 8 a.m. and 6 p.m. were compared with patients presenting during off-hours. Data analysis included time intervals from admission to invasive management (goals: for hr-NSTE-ACS, <2 h; for NSTEMI, <24 h) and the resulting guideline adherence. RESULTS: Guideline-adherent timing of an invasive strategy did not differ significantly between the on-hour (6.5 h [3.0-22.0 h], 79.9 %) and off-hour groups (10.5 h [2.0-20.0 h], 75.3 %; p = 0.94), without additional significant differences between admissions during off-hours Monday to Thursday and weekends (10.0 h [2.0-19.0 h], 75.6 % vs. 7.5 h [2.0-20.0 h], 76.2 %; p = 0.96). CONCLUSION: Our exemplary experience in two different German CPUs demonstrates adequate timing of coronary catheterization in over 75 % of cases, irrespective of admission during on- or off-hours. Nationwide validation of our findings by the German CPU registry is mandatory.
Authors: Christian W Hamm; Jean-Pierre Bassand; Stefan Agewall; Jeroen Bax; Eric Boersma; Hector Bueno; Pio Caso; Dariusz Dudek; Stephan Gielen; Kurt Huber; Magnus Ohman; Mark C Petrie; Frank Sonntag; Miguel Sousa Uva; Robert F Storey; William Wijns; Doron Zahger Journal: Eur Heart J Date: 2011-08-26 Impact factor: 29.983
Authors: Felix Post; Evangelos Giannitsis; Thomas Riemer; Lars S Maier; Claus Schmitt; Burghard Schumacher; Gerd Heusch; Harald Mudra; Thomas Voigtländer; Rainer Erbel; Harald Darius; Hugo Katus; Christian Hamm; Jochen Senges; Tommaso Gori; Thomas Münzel Journal: Clin Res Cardiol Date: 2012-07-25 Impact factor: 5.460
Authors: William J Kostis; Kitaw Demissie; Stephen W Marcella; Yu-Hsuan Shao; Alan C Wilson; Abel E Moreyra Journal: N Engl J Med Date: 2007-03-15 Impact factor: 91.245
Authors: Charles V Pollack; Judd E Hollander; Anita Y Chen; Eric D Peterson; Sripal Bangalore; Frank W Peacock; Christopher P Cannon; John G Canto; Brian W Gibler; Magnus E Ohman; Matthew T Roe Journal: Crit Pathw Cardiol Date: 2009-03