Factors associated with delay in transfer of patients with ST-segment elevation myocardial infarction from first medical contact to catheterization laboratory: Lessons from CRAC, a French prospective multicentre registry

Autor: Jean Capsec, Pelle Stolt, Leslie Grammatico-Guillon, Sandra Gautier, Stephan Chassaing, Christophe Saint Etienne, Pascal Motreff, Grégoire Rangé, Pierre Marcollet, Philippe Dequenne, Franck Albert, L. Godillon, Christophe Laure, R. Hakim
Přispěvatelé: Hôpital Louis Pasteur [Chartres], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Jacques Coeur, Clinique Saint Gatien, Hôpitaux de Chartres [Chartres], Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Maglia Rotta, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Unité d'Épidémiologie des données cliniques [Tours] (EpiDcliC)
Rok vydání: 2018
Předmět:
Male
Patient Transfer
medicine.medical_specialty
Cardiac Catheterization
Time Factors
medicine.medical_treatment
Comorbidity
030204 cardiovascular system & hematology
Coronary Angiography
[SHS]Humanities and Social Sciences
Time-to-Treatment
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Catchment Area
Health
Risk Factors
Internal medicine
Angioplasty
Diabetes mellitus
medicine
ST segment
Humans
030212 general & internal medicine
Myocardial infarction
Prospective Studies
Registries
ComputingMilieux_MISCELLANEOUS
Killip class
Aged
Interventional cardiology
business.industry
Percutaneous coronary intervention
General Medicine
Odds ratio
Middle Aged
medicine.disease
Treatment Outcome
Cardiology
ST Elevation Myocardial Infarction
Female
France
Cardiology and Cardiovascular Medicine
business
Zdroj: Archives of cardiovascular diseases
Archives of cardiovascular diseases, 2019, 112 (1), pp.3-11. ⟨10.1016/j.acvd.2018.04.008⟩
ISSN: 1875-2128
1875-2136
DOI: 10.1016/j.acvd.2018.04.008⟩
Popis: It is critical to minimize the time between the first medical contact and primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.To identify factors associated with a delay of120min between first medical contact and primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.Data were analysed from a regional French registry of patients undergoing coronary angioplasty for ST-segment elevation myocardial infarction24h after symptom onset. Patients (n=2081) were grouped according to transfer times from first medical contact to primary percutaneous coronary intervention:120min; or≤120min. Independent predictors of delay were identified by univariate and multivariable analyses.The median transfer time from first medical contact to primary percutaneous coronary intervention was 112min; 892 patients (42.9%) had a transfer time120min. A delay of120min was significantly associated with:≥75km distance from interventional cardiology centre at symptom onset (odds ratio 7.9); more than one medical practitioner involved before interventional cardiology centre (odds ratio 4.5); first admission to a hospital without an interventional cardiology centre (odds ratio 2.9); absence of emergency call (odds ratio 1.6); ≥90min between symptom onset and first medical contact (odds ratio 1.3); Killip class at admission1 (odds ratio 1.8); lateral ischaemia (odds ratio 1.8); diabetes mellitus (odds ratio 1.6); and hypertension (odds ratio 1.3).In ST-segment elevation myocardial infarction, a transfer time from first medical contact to primary percutaneous coronary intervention of120min was associated with geographic, systemic and comorbid factors, several of which appear reasonably actionable.
Databáze: OpenAIRE
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