The impact of pre-hospital 12-lead electrocardiogram and first contact by cardiologist in patients with ST-elevation myocardial infarction in Kanagawa, Japan
•Initial management of ST-elevation myocardial infarction (STEMI) is crucial.•Pre-hospital 12-lead electrocardiogram (ECG) is useful.•Fast care by cardiologists also plays an important role.•In STEMI registry, pre-hospital 12-lead ECG and initial physician both had impact. Background pre-hospital 12...
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| Veröffentlicht in: | Journal of cardiology 2021-09, Vol.78 (3), p.183-192 |
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| creator | Mori, Hiroyoshi Maeda, Atsuo Akashi, Yoshihiro Ako, Junya Ikari, Yuji Ebina, Toshiaki Tamura, Kouichi Namiki, Atsuo Fukui, Kazuki Michishita, Ichiro Kimura, Kazuo Suzuki, Hiroshi |
| description | •Initial management of ST-elevation myocardial infarction (STEMI) is crucial.•Pre-hospital 12-lead electrocardiogram (ECG) is useful.•Fast care by cardiologists also plays an important role.•In STEMI registry, pre-hospital 12-lead ECG and initial physician both had impact.
Background pre-hospital 12-lead electrocardiogram (ECG) by emergency medical service (EMS) personnel at the site of first medical contact (FMC) and the physician of first contact both play important roles in managing patients with ST-elevation myocardial infarction (STEMI). However, in Japan, pre-hospital 12-lead ECG is not routinely performed by EMS personnel at the site of FMC and the physician of first contact is not always a cardiologist.
Methods from October 2015 to October 2019, 2035 consecutive STEMI patients transported from the field by ambulance were analyzed from the K-ACTIVE registry. Based on the presence (+) or absence (-) of pre-hospital 12-lead ECG / first contact by cardiologist, patients were divided into 4 groups (+/+, +/-, -/+, -/-). Patient characteristics, FMC to door time, door to device time and in-hospital mortality were compared.
Results the numbers of patients in each group were as follows (+/+, n = 987; +/-, n = 211; -/+, n = 610; -/-, n = 227). For patient characteristics, there were significant differences in the prevalence of dyslipidemia and the presence of chest pain. The FMC to door time was similar (median value, +/+, 24 min; +/-, 25 min; -/+, 24 min; -/-, 24 min; p = 0.23). The door to device time was the shortest in the +/+ group (median value, +/+, 65 min; +/-, 80 min; -/+, 69 min; -/-, 88 min; p |
| doi_str_mv | 10.1016/j.jjcc.2021.04.001 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2520881046</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0914508721000903</els_id><sourcerecordid>2520881046</sourcerecordid><originalsourceid>FETCH-LOGICAL-c424t-9b663ed1a4820b5385a215882b1de06bf1a9468b58b0cb1a744ec9d4081662403</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS0EotvCH-CAfORAwthxvI7EBVWFApU4sJytiePsOkriYHtb7Y_hv-IlhSMnS8_vvdHMR8grBiUDJt8N5TAYU3LgrARRArAnZMPUVhZiW6mnZAMNE0UNantBLmMcACQ0Sj4nF1XVcLmVbEN-7Q6WumlBk6jv6RJscfBxcQlHyngxWuyoHa1JwRsMnfP7gBPFuaO9CzFR4-d0zrYnuv6Pfu-y7ma6YHJ2TpE-uHSg33dF7rnPmp_pdFrb8hA39xjMHzVnvuKMe3zAt_QLLji_IM96HKN9-fhekR8fb3bXt8Xdt0-frz_cFUZwkYqmlbKyHUOhOLR1pWrkrFaKt6yzINueYSOkamvVgmkZboWwpukEKCYlF1BdkTdr7xL8z6ONSU8uGjuOOFt_jJrXHJRiIGS28tVqgo8x2F4vwU0YTpqBPmPRgz5j0WcsGoTOWHLo9WP_sZ1s9y_yl0M2vF8NNm9572zQ0eTjGdu5kI-vO-_-1_8bJMqf7A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2520881046</pqid></control><display><type>article</type><title>The impact of pre-hospital 12-lead electrocardiogram and first contact by cardiologist in patients with ST-elevation myocardial infarction in Kanagawa, Japan</title><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Mori, Hiroyoshi ; Maeda, Atsuo ; Akashi, Yoshihiro ; Ako, Junya ; Ikari, Yuji ; Ebina, Toshiaki ; Tamura, Kouichi ; Namiki, Atsuo ; Fukui, Kazuki ; Michishita, Ichiro ; Kimura, Kazuo ; Suzuki, Hiroshi</creator><creatorcontrib>Mori, Hiroyoshi ; Maeda, Atsuo ; Akashi, Yoshihiro ; Ako, Junya ; Ikari, Yuji ; Ebina, Toshiaki ; Tamura, Kouichi ; Namiki, Atsuo ; Fukui, Kazuki ; Michishita, Ichiro ; Kimura, Kazuo ; Suzuki, Hiroshi</creatorcontrib><description>•Initial management of ST-elevation myocardial infarction (STEMI) is crucial.•Pre-hospital 12-lead electrocardiogram (ECG) is useful.•Fast care by cardiologists also plays an important role.•In STEMI registry, pre-hospital 12-lead ECG and initial physician both had impact.
Background pre-hospital 12-lead electrocardiogram (ECG) by emergency medical service (EMS) personnel at the site of first medical contact (FMC) and the physician of first contact both play important roles in managing patients with ST-elevation myocardial infarction (STEMI). However, in Japan, pre-hospital 12-lead ECG is not routinely performed by EMS personnel at the site of FMC and the physician of first contact is not always a cardiologist.
Methods from October 2015 to October 2019, 2035 consecutive STEMI patients transported from the field by ambulance were analyzed from the K-ACTIVE registry. Based on the presence (+) or absence (-) of pre-hospital 12-lead ECG / first contact by cardiologist, patients were divided into 4 groups (+/+, +/-, -/+, -/-). Patient characteristics, FMC to door time, door to device time and in-hospital mortality were compared.
Results the numbers of patients in each group were as follows (+/+, n = 987; +/-, n = 211; -/+, n = 610; -/-, n = 227). For patient characteristics, there were significant differences in the prevalence of dyslipidemia and the presence of chest pain. The FMC to door time was similar (median value, +/+, 24 min; +/-, 25 min; -/+, 24 min; -/-, 24 min; p = 0.23). The door to device time was the shortest in the +/+ group (median value, +/+, 65 min; +/-, 80 min; -/+, 69 min; -/-, 88 min; p < 0.0001). Crude in-hospital mortality was the highest in the -/- group (+/+, 3.9%; +/-, 2.4%; -/+, 5.8%; -/-, 11.9%; p < 0.0001). After adjustment for age and sex, the adjusted odds ratios for in-hospital mortality were as follows [odds ratio (with 95% confidence interval) +/+, 0.33 [0.19-0.57]; +/-, 0.19 [0.07–0.52]; -/+, 0.49 [0.29–0.86]; -/-, 1 [reference)].
Conclusion pre-hospital 12-lead ECG and the physician of first contact had a significant impact on the door to device time and in-hospital mortality. Continuous efforts should be made to improve acute management of STEMI.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2021.04.001</identifier><identifier>PMID: 33926761</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Acute myocardial infarction ; Physician of first contact ; Pre-hospital 12-lead electrocardiogram</subject><ispartof>Journal of cardiology, 2021-09, Vol.78 (3), p.183-192</ispartof><rights>2021</rights><rights>Copyright © 2021. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-9b663ed1a4820b5385a215882b1de06bf1a9468b58b0cb1a744ec9d4081662403</citedby><cites>FETCH-LOGICAL-c424t-9b663ed1a4820b5385a215882b1de06bf1a9468b58b0cb1a744ec9d4081662403</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jjcc.2021.04.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33926761$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mori, Hiroyoshi</creatorcontrib><creatorcontrib>Maeda, Atsuo</creatorcontrib><creatorcontrib>Akashi, Yoshihiro</creatorcontrib><creatorcontrib>Ako, Junya</creatorcontrib><creatorcontrib>Ikari, Yuji</creatorcontrib><creatorcontrib>Ebina, Toshiaki</creatorcontrib><creatorcontrib>Tamura, Kouichi</creatorcontrib><creatorcontrib>Namiki, Atsuo</creatorcontrib><creatorcontrib>Fukui, Kazuki</creatorcontrib><creatorcontrib>Michishita, Ichiro</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><creatorcontrib>Suzuki, Hiroshi</creatorcontrib><title>The impact of pre-hospital 12-lead electrocardiogram and first contact by cardiologist in patients with ST-elevation myocardial infarction in Kanagawa, Japan</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>•Initial management of ST-elevation myocardial infarction (STEMI) is crucial.•Pre-hospital 12-lead electrocardiogram (ECG) is useful.•Fast care by cardiologists also plays an important role.•In STEMI registry, pre-hospital 12-lead ECG and initial physician both had impact.
Background pre-hospital 12-lead electrocardiogram (ECG) by emergency medical service (EMS) personnel at the site of first medical contact (FMC) and the physician of first contact both play important roles in managing patients with ST-elevation myocardial infarction (STEMI). However, in Japan, pre-hospital 12-lead ECG is not routinely performed by EMS personnel at the site of FMC and the physician of first contact is not always a cardiologist.
Methods from October 2015 to October 2019, 2035 consecutive STEMI patients transported from the field by ambulance were analyzed from the K-ACTIVE registry. Based on the presence (+) or absence (-) of pre-hospital 12-lead ECG / first contact by cardiologist, patients were divided into 4 groups (+/+, +/-, -/+, -/-). Patient characteristics, FMC to door time, door to device time and in-hospital mortality were compared.
Results the numbers of patients in each group were as follows (+/+, n = 987; +/-, n = 211; -/+, n = 610; -/-, n = 227). For patient characteristics, there were significant differences in the prevalence of dyslipidemia and the presence of chest pain. The FMC to door time was similar (median value, +/+, 24 min; +/-, 25 min; -/+, 24 min; -/-, 24 min; p = 0.23). The door to device time was the shortest in the +/+ group (median value, +/+, 65 min; +/-, 80 min; -/+, 69 min; -/-, 88 min; p < 0.0001). Crude in-hospital mortality was the highest in the -/- group (+/+, 3.9%; +/-, 2.4%; -/+, 5.8%; -/-, 11.9%; p < 0.0001). After adjustment for age and sex, the adjusted odds ratios for in-hospital mortality were as follows [odds ratio (with 95% confidence interval) +/+, 0.33 [0.19-0.57]; +/-, 0.19 [0.07–0.52]; -/+, 0.49 [0.29–0.86]; -/-, 1 [reference)].
Conclusion pre-hospital 12-lead ECG and the physician of first contact had a significant impact on the door to device time and in-hospital mortality. Continuous efforts should be made to improve acute management of STEMI.</description><subject>Acute myocardial infarction</subject><subject>Physician of first contact</subject><subject>Pre-hospital 12-lead electrocardiogram</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kUFv1DAQhS0EotvCH-CAfORAwthxvI7EBVWFApU4sJytiePsOkriYHtb7Y_hv-IlhSMnS8_vvdHMR8grBiUDJt8N5TAYU3LgrARRArAnZMPUVhZiW6mnZAMNE0UNantBLmMcACQ0Sj4nF1XVcLmVbEN-7Q6WumlBk6jv6RJscfBxcQlHyngxWuyoHa1JwRsMnfP7gBPFuaO9CzFR4-d0zrYnuv6Pfu-y7ma6YHJ2TpE-uHSg33dF7rnPmp_pdFrb8hA39xjMHzVnvuKMe3zAt_QLLji_IM96HKN9-fhekR8fb3bXt8Xdt0-frz_cFUZwkYqmlbKyHUOhOLR1pWrkrFaKt6yzINueYSOkamvVgmkZboWwpukEKCYlF1BdkTdr7xL8z6ONSU8uGjuOOFt_jJrXHJRiIGS28tVqgo8x2F4vwU0YTpqBPmPRgz5j0WcsGoTOWHLo9WP_sZ1s9y_yl0M2vF8NNm9572zQ0eTjGdu5kI-vO-_-1_8bJMqf7A</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Mori, Hiroyoshi</creator><creator>Maeda, Atsuo</creator><creator>Akashi, Yoshihiro</creator><creator>Ako, Junya</creator><creator>Ikari, Yuji</creator><creator>Ebina, Toshiaki</creator><creator>Tamura, Kouichi</creator><creator>Namiki, Atsuo</creator><creator>Fukui, Kazuki</creator><creator>Michishita, Ichiro</creator><creator>Kimura, Kazuo</creator><creator>Suzuki, Hiroshi</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210901</creationdate><title>The impact of pre-hospital 12-lead electrocardiogram and first contact by cardiologist in patients with ST-elevation myocardial infarction in Kanagawa, Japan</title><author>Mori, Hiroyoshi ; Maeda, Atsuo ; Akashi, Yoshihiro ; Ako, Junya ; Ikari, Yuji ; Ebina, Toshiaki ; Tamura, Kouichi ; Namiki, Atsuo ; Fukui, Kazuki ; Michishita, Ichiro ; Kimura, Kazuo ; Suzuki, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-9b663ed1a4820b5385a215882b1de06bf1a9468b58b0cb1a744ec9d4081662403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute myocardial infarction</topic><topic>Physician of first contact</topic><topic>Pre-hospital 12-lead electrocardiogram</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mori, Hiroyoshi</creatorcontrib><creatorcontrib>Maeda, Atsuo</creatorcontrib><creatorcontrib>Akashi, Yoshihiro</creatorcontrib><creatorcontrib>Ako, Junya</creatorcontrib><creatorcontrib>Ikari, Yuji</creatorcontrib><creatorcontrib>Ebina, Toshiaki</creatorcontrib><creatorcontrib>Tamura, Kouichi</creatorcontrib><creatorcontrib>Namiki, Atsuo</creatorcontrib><creatorcontrib>Fukui, Kazuki</creatorcontrib><creatorcontrib>Michishita, Ichiro</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><creatorcontrib>Suzuki, Hiroshi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mori, Hiroyoshi</au><au>Maeda, Atsuo</au><au>Akashi, Yoshihiro</au><au>Ako, Junya</au><au>Ikari, Yuji</au><au>Ebina, Toshiaki</au><au>Tamura, Kouichi</au><au>Namiki, Atsuo</au><au>Fukui, Kazuki</au><au>Michishita, Ichiro</au><au>Kimura, Kazuo</au><au>Suzuki, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of pre-hospital 12-lead electrocardiogram and first contact by cardiologist in patients with ST-elevation myocardial infarction in Kanagawa, Japan</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>78</volume><issue>3</issue><spage>183</spage><epage>192</epage><pages>183-192</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>•Initial management of ST-elevation myocardial infarction (STEMI) is crucial.•Pre-hospital 12-lead electrocardiogram (ECG) is useful.•Fast care by cardiologists also plays an important role.•In STEMI registry, pre-hospital 12-lead ECG and initial physician both had impact.
Background pre-hospital 12-lead electrocardiogram (ECG) by emergency medical service (EMS) personnel at the site of first medical contact (FMC) and the physician of first contact both play important roles in managing patients with ST-elevation myocardial infarction (STEMI). However, in Japan, pre-hospital 12-lead ECG is not routinely performed by EMS personnel at the site of FMC and the physician of first contact is not always a cardiologist.
Methods from October 2015 to October 2019, 2035 consecutive STEMI patients transported from the field by ambulance were analyzed from the K-ACTIVE registry. Based on the presence (+) or absence (-) of pre-hospital 12-lead ECG / first contact by cardiologist, patients were divided into 4 groups (+/+, +/-, -/+, -/-). Patient characteristics, FMC to door time, door to device time and in-hospital mortality were compared.
Results the numbers of patients in each group were as follows (+/+, n = 987; +/-, n = 211; -/+, n = 610; -/-, n = 227). For patient characteristics, there were significant differences in the prevalence of dyslipidemia and the presence of chest pain. The FMC to door time was similar (median value, +/+, 24 min; +/-, 25 min; -/+, 24 min; -/-, 24 min; p = 0.23). The door to device time was the shortest in the +/+ group (median value, +/+, 65 min; +/-, 80 min; -/+, 69 min; -/-, 88 min; p < 0.0001). Crude in-hospital mortality was the highest in the -/- group (+/+, 3.9%; +/-, 2.4%; -/+, 5.8%; -/-, 11.9%; p < 0.0001). After adjustment for age and sex, the adjusted odds ratios for in-hospital mortality were as follows [odds ratio (with 95% confidence interval) +/+, 0.33 [0.19-0.57]; +/-, 0.19 [0.07–0.52]; -/+, 0.49 [0.29–0.86]; -/-, 1 [reference)].
Conclusion pre-hospital 12-lead ECG and the physician of first contact had a significant impact on the door to device time and in-hospital mortality. Continuous efforts should be made to improve acute management of STEMI.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>33926761</pmid><doi>10.1016/j.jjcc.2021.04.001</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute myocardial infarction Physician of first contact Pre-hospital 12-lead electrocardiogram |
| title | The impact of pre-hospital 12-lead electrocardiogram and first contact by cardiologist in patients with ST-elevation myocardial infarction in Kanagawa, Japan |
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