Klaudiusz Nadolny1, Jerzy R Ładny2, Robert Gałązkowski3, Mariusz Gąsior4, Jacek Kubica5, Dorota Zyśko6, Jarosław Kaźmierczak7, Piotr Ponikowski8. 1. Department of Emergency Medicine, Medical University of Białystok, Białystok, Poland; Faculty of Medicine, Katowice School of Technology, Katowice, Poland; Department of Emergency Medical Service, Higher School of Strategic Planning, Dąbrowa Górnicza, Poland. knadolny@wpr.pl 2. Department of Emergency Medicine, Medical University of Białystok, Białystok, Poland 3. Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland 4. 3rd Department of Cardiology, Silesian Center for Heart Diseases,Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland 5. Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland 6. Department and Clinic of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland 7. Department of Cardiology, Pomeranian Medical University, Szczecin, Poland 8. Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland; Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
Abstract
BACKGROUND: The National Emergency Medical Services Management Support System, a unique information and communication technology system, was developed to reduce the burden of ST-segment elevation myocardial infarction (STEMI) in Poland. According to the European Society of Cardiology guidelines, medical emergency teams (METs) should diagnose STEMI using electrocardiogram (ECG) transmission and apply dual antiplatelet therapy (DAPT) as a pivotal treatment. AIMS: This study aimed to analyze MET interventions in patients with STEMI and assess regional differences in the management in Poland. METHODS: Using ambulance call reports, we retrospectively analyzed MET interventions due to conditions classified as I21 (acute myocardial infarction; according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision), which were performed in Poland between January 1, 2018 and December 31, 2018. RESULTS: In 2018, METs conducted 16 807 interventions classified as I21, which accounted for 0.5% of all MET interventions in Poland in that year. Most interventions were conducted in the Mazovia Province (13.4%; P <0.001), and the lowest number was reported in the Podlasie Province (2.5%). A 12‑lead ECG was performed during 98.6% of interventions, and ECG transmission in 37.49%: most often in the Mazovia Province (59.62%; P <0.001), and least often in the Lublin Province (13.8%). In 72.12% of interventions, DAPT was applied: clopidogrel was the P2Y12 inhibitor used in 49.68% of interventions, and ticagrelor in 25.14% (P <0.001). A P2Y12 inhibitor was most often used in the Wielkopolska Province (98.4%), and least often in the Silesia Province (40.34%). CONCLUSIONS: Significant differences in the implementation of the European Society of Cardiology guidelines regarding ECG transmission and DAPT were observed between particular provinces in Poland.
BACKGROUND: The National Emergency Medical Services Management Support System, a unique information and communication technology system, was developed to reduce the burden of ST-segment elevation myocardial infarction (STEMI) in Poland. According to the European Society of Cardiology guidelines, medical emergency teams (METs) should diagnose STEMI using electrocardiogram (ECG) transmission and apply dual antiplatelet therapy (DAPT) as a pivotal treatment. AIMS: This study aimed to analyze MET interventions in patients with STEMI and assess regional differences in the management in Poland. METHODS: Using ambulance call reports, we retrospectively analyzed MET interventions due to conditions classified as I21 (acute myocardial infarction; according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision), which were performed in Poland between January 1, 2018 and December 31, 2018. RESULTS: In 2018, METs conducted 16 807 interventions classified as I21, which accounted for 0.5% of all MET interventions in Poland in that year. Most interventions were conducted in the Mazovia Province (13.4%; P <0.001), and the lowest number was reported in the Podlasie Province (2.5%). A 12‑lead ECG was performed during 98.6% of interventions, and ECG transmission in 37.49%: most often in the Mazovia Province (59.62%; P <0.001), and least often in the Lublin Province (13.8%). In 72.12% of interventions, DAPT was applied: clopidogrel was the P2Y12 inhibitor used in 49.68% of interventions, and ticagrelor in 25.14% (P <0.001). A P2Y12 inhibitor was most often used in the Wielkopolska Province (98.4%), and least often in the Silesia Province (40.34%). CONCLUSIONS: Significant differences in the implementation of the European Society of Cardiology guidelines regarding ECG transmission and DAPT were observed between particular provinces in Poland.
Authors: Piotr Niezgoda; Malwina Barańska; Piotr Adamski; Łukasz Pietrzykowski; Michał Piotr Marszałł; Wojciech Wojakowski; Wiktor Kuliczkowski; Diana Gorog; Bernd Jilma; Klaudiusz Nadolny; Eliano Pio Navarese; Aldona Kubica; Jacek Kubica Journal: Cardiol J Date: 2021-10-13 Impact factor: 2.737