Outcome in Patients Transferred for Percutaneous Coronary Intervention (A National Registry of Myocardial Infarction 2/3/4 Analysis)

Hospital transfer is associated with delays in performance of primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction. Given the limited number of interventional centers in the United States, the transfer of patients is widely practiced. We compared the outcome of patients who were transferred for primary PCI and determined whether prolonged door-to-balloon times were associated with increased mortality. Patients who presented within 12 hours with ST-segment elevation myocardial infarction and underwent transfer for primary PCI were identified from the National Registry of Myocardial Infarction database (NRMI databases 2, 3, and 4, n = 7,133). The short-term outcome of those who received early (≤2 hours) was compared with that of those who received delayed primary PCI (>2 hours) using multivariate logistic regression analyses and propensity score methods. The door-to-balloon time for the early PCI group compared with the delayed PCI group was 99 ± 16 versus 264 ± 178 minutes, respectively (p