First medical contact place determines prognosis in a regional STEMI network. Is time the most important factor?
| Autor: | RM Lidon, Cosme García-García, Marc Ferrer, Teresa Oliveras, Ferran Rueda, Jordi Serra, Rut Andrea, A Bayes-Genis, Helena Tizón, Carlos Labata, Xavier Carrillo, N El Ouaddi, Fina Mauri, O De Diego |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Ischemia Atrial fibrillation General Medicine Critical Care and Intensive Care Medicine medicine.disease Revascularization Coronary artery bypass surgery Reperfusion therapy Internal medicine Ventricular fibrillation Cardiology Medicine Intubation Cardiology and Cardiovascular Medicine business Atrioventricular block |
| Zdroj: | European Heart Journal. Acute Cardiovascular Care. 10 |
| ISSN: | 2048-8734 2048-8726 |
| DOI: | 10.1093/ehjacc/zuab020.131 |
| Popis: | Funding Acknowledgements Type of funding sources: None. OnBehalf Codi IAM investigators Background Long revascularization times have been associated with worse prognosis in PCI-treated STEMI patients. Thus, efforts have been focused in optimizing revascularization times. In Catalonia, the different first medical contact (FMC) points with the regional STEMI network CODI IAM have been associated with different degrees of delay in reperfusion. Purpose we aim to determine if our regional STEMI network achieves better mortality rates in the fastest circuits than in slower ones by optimizing revascularization times. Methods since CODI IAM network was launched in June 2009, a prospective registry of all attended cases is conducted. We included in the study all patients with final STEMI diagnosis treated with primary PCI from January 2010 to December 2016. Patients were divided in 4 different groups regarding FMC point: primary care center (PCC), community hospital (CH), PCI-hospital (PCI-H), emergency medical services (EMS)). Clinical data, reperfusion times and 30-day and 1-year mortality were analyzed. Results a total of 14,483 patients (PCC 19%, CH 35,7%, PCI-H 12,5%; EMS 32,7%) were included in the analysis. Women proportion was higher in hospital-attended cases (p 120 min (HR 1,56 (1,20-2,03), p = 0,001 for PCI-H 30-day mortality and HR 1,48 (1,21-1,82), p Conclusions considering that reperfusion time intervals favour EMS and PCI-H groups, crude between-groups mortality differences might be justified by a selection bias rather than by the pathway itself. Despite this probable selection bias, the STEMI network achieves a reduction of these differences by shortening reperfusion times in EMS and PCI-H groups. Abstract Figure. 1-year mortality curves |
| Databáze: | OpenAIRE |
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