Comparison of primary angioplasty in rural and metropolitan areas within an integrated network.

Autor:	Giuliani G; Invasive Cardiology 2, Careggi Hospital, Florence, Italy. gabriele_giuliani@tiscali.it, Bonechi F, Vecchio S, Biondi-Zoccai GG, Nieri M, Vittori G, Spaziani G, Nassi F, Chechi T, Di Mario C, Zipoli A, Margheri M
Jazyk:	angličtina
Zdroj:	EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2008 Nov; Vol. 4 (3), pp. 365-72.
DOI:	10.4244/eijv4i3a65
Abstrakt:	Aims: To compare reperfusion times and in-hospital outcome of patients with STEMI treated with primary percutaneous coronary intervention (PCI) in a teaching hospital (TH) with or without inter-hospital transfer and in community hospitals. Methods and Results: We performed a retrospective analysis of 536 patients with STEMI treated between January 2005 and December 2006 with primary PCI. Three groups were identified. A: 207 patients presented to the TH. B: 121 patients transferred to TH from metropolitan area hospitals (MAH). C: 208 patients presented in two rural area hospitals (RAH) with primary PCI capability. Baseline characteristics were similar. Door-to-balloon (DtB) times were significantly (p<0.001) higher in group B (median 120, range 90-180 min) both compared to group A (median 60, range 45-90 min) and C (median 73, range 55-99 min). In group B 79,5% of patients present a DtB > 90 min. In-hospital mortality was 4.9%, 3.3% and 4.3% respectively in group A, B and C without significant differences. Conclusions: The expansion of primary PCI to RAH achieves reperfusion delays similar to that of patients admitted to TH. Transferred patients present very higher DtB when compared to patients treated on-site. In-hospital outcome are similar but further studies are warranted.
Databáze:	MEDLINE
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