Dataset Information

Time From Distress Call to Percutaneous Coronary Intervention and Outcomes in Myocardial Infarction.

ABSTRACT:

Background

Early percutaneous coronary intervention (PCI) is recommended for ST-segment elevation myocardial infarction (STEMI) treatment. Delays in time-to-PCI, kept within guideline recommendations, have seldom been investigated.

Objectives

The purpose of this study was to investigate the consequences of delay, due to system factors or hospital distance, for the time between last patient distress call and PCI.

Methods

Registry-based cohort study including times of first call to medical services, admission and PCI for patients admitted with STEMI in Copenhagen, Denmark (2014-2018). The main combined outcome included death, recurrent myocardial infarction, or heart failure estimated at 30 days and 1 year from event. Outcomes according to time from call to PCI (system delay) and door-to-balloon time were standardized to the STEMI population using multivariate logistic regression.

Results

In total, 1,822 STEMI patients (73.5% male, median age 63.3 years [Q1-Q3: 54.6-72.9 years]) called the emergency services ≤72 hours before PCI (1,735, ≤12 hours). The combined endpoint of 1-year cumulative incidence was 13.9% (166/1,196) for patients treated within 120 minutes of the call and 21.2% (89/420) for patients treated later. Standardized 30-day outcomes were 7.33% (95% CI: 5.41%-9.63%) for patients treated <60 minutes, and 11.1% (95% CI: 8.39%-14.2%) for patients treated >120 minutes.

Conclusions

The risk of recurrent myocardial infarction, death, and heart failure following PCI treatment of STEMI increases rapidly when delay exceeds 1 hour. This indicates a particular advantage of minimizing time from first contact to PCI.

SUBMITTER: Mills EHA

PROVIDER: S-EPMC11312358 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

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Publications

Time From Distress Call to Percutaneous Coronary Intervention and Outcomes in Myocardial Infarction.

Mills Elisabeth Helen Anna EHA Møller Amalie Lykkemark AL Engstrøm Thomas T Folke Fredrik F Pedersen Frants F Køber Lars L Gnesin Filip F Zylyftari Nertila N Blomberg Stig Nikolaj Fasmer SNF Kragholm Kristian K Gislason Gunnar G Jensen Britta B Lippert Freddy F Kragelund Charlotte C Christensen Helle Collatz HC Andersen Mikkel Porsborg MP Torp-Pedersen Christian C

JACC. Advances 20240603 7

<h4>Background</h4>Early percutaneous coronary intervention (PCI) is recommended for ST-segment elevation myocardial infarction (STEMI) treatment. Delays in time-to-PCI, kept within guideline recommendations, have seldom been investigated.<h4>Objectives</h4>The purpose of this study was to investigate the consequences of delay, due to system factors or hospital distance, for the time between last patient distress call and PCI.<h4>Methods</h4>Registry-based cohort study including times of first c ...[more]

PMID: 39129988

Similar Datasets

Project description:To describe the impact of delayed call time for chest pain in the salvage of ST-segment elevation myocardial infarction (STEMI) patients and its associated independent risk factors, and to identify risk factors associated with cumulative morbidity and mortality in STEMI patients at 4 years after percutaneous coronary intervention (PCI). Retrospective analysis of 398 patients diagnosed with STEMI and treated with emergency PCI within 24 hours of symptom onset in Fuyang People's Hospital from April 2018 to April 2021. The enrolled patients were divided into ≤60 minutes group (193 cases), and > 60 minutes group (205 cases), according to the delayed call time of patients with chest pain. Analysis of basic clinical data, rescue time, and major cardiovascular adverse events in the 2 groups. Multifactorial logistic regression analysis of independent correlates of delayed chest pain calls and Cox proportional risk regression modeling of risk factors for cumulative morbidity and mortality at 4 years after surgery. Compared to the delayed call time ≤ 60 minutes group, the > 60 minutes group had a higher proportion of females, a history of diabetes, rural remote areas, and farmer occupation (P < .05). Binary logistic regression analysis shows the history of diabetes and female as independent risk factors for delayed call time >60 minutes for chest pain. In the delayed call time ≤60 minutes group, the time from symptom onset-to-balloon (S0-to-B) and from symptom onset-to-first medical contact (SO-to-FMC) were smaller than in the delayed call time >60 minutes group (P < .05). The sum of postinfarction angina and major cardiovascular adverse events was lower in the group with delayed call time ≤60 minutes than in the group with delayed call time >60 minutes (P < .05). The Kaplan-Meier survival curve and the survival curve without the occurrence of major adverse cardiovascular events were statistically significant in both groups (P < .05). Multifactorial Cox regression analysis showed that delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III were all risk factors for cumulative morbidity and mortality at 4 years after PCI in patients with STEMI. Delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III are all risk factors for cumulative morbidity and mortality in STEMI patients at 4 years after PCI. Reducing the delayed call time for chest pain can improve the long-term prognosis of patients.

Dataset Information

Time From Distress Call to Percutaneous Coronary Intervention and Outcomes in Myocardial Infarction.

Background

Objectives

Methods

Results

Conclusions

Publications

Time From Distress Call to Percutaneous Coronary Intervention and Outcomes in Myocardial Infarction.

Similar Datasets

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