Pre-hospital ambulance notification and initiation of treatment of ST elevation myocardial infarction is associated with significant reduction in door-to-balloon time for primary PCI

Savage, Michael L., Poon, Karl K.C., Johnston, Erin M., Raffel, Owen Christopher, Incani, Alexander, Bryant, John, Rashford, Stephen, Pincus, Matthew and Walters, Darren L. (2014) Pre-hospital ambulance notification and initiation of treatment of ST elevation myocardial infarction is associated with significant reduction in door-to-balloon time for primary PCI. Heart Lung and Circulation, 23 5: 435-443. doi:10.1016/j.hlc.2013.11.015


Author Savage, Michael L.
Poon, Karl K.C.
Johnston, Erin M.
Raffel, Owen Christopher
Incani, Alexander
Bryant, John
Rashford, Stephen
Pincus, Matthew
Walters, Darren L.
Title Pre-hospital ambulance notification and initiation of treatment of ST elevation myocardial infarction is associated with significant reduction in door-to-balloon time for primary PCI
Journal name Heart Lung and Circulation   Check publisher's open access policy
ISSN 1443-9506
1444-2892
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.hlc.2013.11.015
Open Access Status
Volume 23
Issue 5
Start page 435
End page 443
Total pages 9
Place of publication Chatswood, NSW Australia
Publisher Elsevier
Language eng
Abstract Background: Mortality in ST elevation myocardial infarction (STEMI) is strongly predicted by the time from first medical contact to reperfusion. The aim of this study was to examine the impact of pre-hospital diagnosis by paramedics in the field on the door-to-balloon (DTB) times of patients with ST elevation myocardial infarction undergoing primary percutaneous intervention. Methods: Paramedics in the field identified patients with ST elevation myocardial infarction on a 12-lead electrocardiograph, activated the cardiac catheter laboratory team from the field and initiated therapy with anticoagulants and antiplatelet agents in the pre-hospital setting. This cohort of patients was compared to a similar group of patients without pre-hospital diagnosis and notification. The primary outcome measure was DTB times. A secondary end point was mortality at 30 days and mortality at six months. Results: A total of 281 patients, mean age of 61.1. ±. 12.9 years underwent primary percutaneous intervention with pre-hospital notification occurring in 63 cases. DTB times were lower in those with pre notification than in those without pre-hospital notification (40.4 vs. 75.6. minutes, p. <. 0.001). This represented a 47.6% shorter DTB time. A non-statistically significant mortality reduction at one month and six months was observed in the pre-hospital notification group (1.6 versus 4.3%, p= 0.307 and 1.6 versus 6.4%, p= 0.203, respectively). Conclusion: Pre-hospital intervention at our centre had a powerful effect in reducing the time to reperfusion in patients with STEMI undergoing primary percutaneous intervention.
Keyword Angioplasty
ECG
Myocardial infarction
ST elevation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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