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 pat...
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| Veröffentlicht in: | The American journal of cardiology 2005-11, Vol.96 (9), p.1227-1232 |
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| creator | Shavelle, David M. Rasouli, M. Leila Frederick, Paul Gibson, C. Michael French, William J. |
| description | 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 |
| doi_str_mv | 10.1016/j.amjcard.2005.06.061 |
| format | Article |
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Leila ; Frederick, Paul ; Gibson, C. Michael ; French, William J.</creator><creatorcontrib>Shavelle, David M. ; Rasouli, M. Leila ; Frederick, Paul ; Gibson, C. Michael ; French, William J. ; National Registry of Myocardial Infarction Investigators</creatorcontrib><description><![CDATA[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 <0.0001). The early PCI group had less recurrent ischemia and angina (5.8% vs 10.1%, p <0.001), less cardiogenic shock (5.1% vs 8.9%, p <0.001), and shorter length of hospital stay (4.4 ± 3.5 vs 5.4 ± 4.7 days, p <0.001). In-hospital mortality was lower for the early PCI group than for the delayed PCI group (2.7% vs 6.2%, p <0.001; entire cohort 5.7%). Comparison of patients matched on propensity score (n = 993) showed that mortality was lower in the early than in the delayed PCI group (2.6% vs 4.6%, p = 0.014, c-statistic 0.67). In conclusion, <4% of patients who received PCI were treated within the recommended guideline of <120 minutes by the American College of Cardiology/American Heart Association. Door-to-balloon times <2 hours in patients who undergo transfer for PCI is associated with a significant decrease in short-term mortality, which suggests that efforts must be made to decrease transfer delays.]]></description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2005.06.061</identifier><identifier>PMID: 16253587</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiology. Vascular system ; Clinical outcomes ; Coronary heart disease ; Electrocardiography ; Female ; Follow-Up Studies ; Heart ; Heart attacks ; Hospital Mortality - trends ; Hospitalization ; Humans ; Male ; Medical sciences ; Medical treatment ; Middle Aged ; Myocardial Infarction - mortality ; Myocardial Infarction - physiopathology ; Myocardial Infarction - therapy ; Myocarditis. Cardiomyopathies ; Patient admissions ; Patient Transfer ; Prognosis ; Registries ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; United States</subject><ispartof>The American journal of cardiology, 2005-11, Vol.96 (9), p.1227-1232</ispartof><rights>2005 Elsevier Inc.</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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Leila</creatorcontrib><creatorcontrib>Frederick, Paul</creatorcontrib><creatorcontrib>Gibson, C. Michael</creatorcontrib><creatorcontrib>French, William J.</creatorcontrib><creatorcontrib>National Registry of Myocardial Infarction Investigators</creatorcontrib><title>Outcome in Patients Transferred for Percutaneous Coronary Intervention (A National Registry of Myocardial Infarction 2/3/4 Analysis)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description><![CDATA[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 <0.0001). The early PCI group had less recurrent ischemia and angina (5.8% vs 10.1%, p <0.001), less cardiogenic shock (5.1% vs 8.9%, p <0.001), and shorter length of hospital stay (4.4 ± 3.5 vs 5.4 ± 4.7 days, p <0.001). In-hospital mortality was lower for the early PCI group than for the delayed PCI group (2.7% vs 6.2%, p <0.001; entire cohort 5.7%). Comparison of patients matched on propensity score (n = 993) showed that mortality was lower in the early than in the delayed PCI group (2.6% vs 4.6%, p = 0.014, c-statistic 0.67). In conclusion, <4% of patients who received PCI were treated within the recommended guideline of <120 minutes by the American College of Cardiology/American Heart Association. Door-to-balloon times <2 hours in patients who undergo transfer for PCI is associated with a significant decrease in short-term mortality, which suggests that efforts must be made to decrease transfer delays.]]></description><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Clinical outcomes</subject><subject>Coronary heart disease</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Hospital Mortality - trends</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Patient admissions</subject><subject>Patient Transfer</subject><subject>Prognosis</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV-L1DAUxYMo7rj6EZQgKO5DZ5K0TdMnGQZ1B1Z3kfU5ZG5vJKVt1qRdmHc_-KZOYWFfhAv5w-8ezr2HkLecrTnjctOuTd-CCc1aMFaumUzFn5EVV1Wd8Zrnz8mKMSaymhf1GXkVY5uenJfyJTnjUpR5qaoV-Xs9jeB7pG6gN2Z0OIyR3gYzRIshYEOtD_QGA0yjGdBPke588IMJR7ofRgz3qcH5gX7a0h9mvpmO_sTfLo6J8JZ-P_rZpEvf-8GaAP9osck3Bd0m-BhdvHhNXljTRXyznOfk19cvt7vL7Or62363vcqgUHLMkMsclGLSskOJUqKscoN1UUqlDgwsgBSYBrQVSuC1KqABYywaNEahgPycfDzp3gX_Z8I46t5FwK47jaalqgohCp7A90_A1k8h2Y1a5CyXsizyBJUnCIKPMaDVd8H1aTOaMz1npFu9ZKTnjDSTqWbxd4v4dOixeexaQknAhwUwEUxnUxrg4iNXiZoLXibu84nDtLN7h0FHSAECNi4gjLrx7j9WHgAaI7OU</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Shavelle, David M.</creator><creator>Rasouli, M. 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Michael ; French, William J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c486t-e163c8806f0b5e66e673ae945688b0cfcc62e156f7e6c1984cdcaafeaeaa8e2c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Cardiology. 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Cardiomyopathies</topic><topic>Patient admissions</topic><topic>Patient Transfer</topic><topic>Prognosis</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shavelle, David M.</creatorcontrib><creatorcontrib>Rasouli, M. Leila</creatorcontrib><creatorcontrib>Frederick, Paul</creatorcontrib><creatorcontrib>Gibson, C. Michael</creatorcontrib><creatorcontrib>French, William J.</creatorcontrib><creatorcontrib>National Registry of Myocardial Infarction Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shavelle, David M.</au><au>Rasouli, M. Leila</au><au>Frederick, Paul</au><au>Gibson, C. Michael</au><au>French, William J.</au><aucorp>National Registry of Myocardial Infarction Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome in Patients Transferred for Percutaneous Coronary Intervention (A National Registry of Myocardial Infarction 2/3/4 Analysis)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>96</volume><issue>9</issue><spage>1227</spage><epage>1232</epage><pages>1227-1232</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract><![CDATA[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 <0.0001). The early PCI group had less recurrent ischemia and angina (5.8% vs 10.1%, p <0.001), less cardiogenic shock (5.1% vs 8.9%, p <0.001), and shorter length of hospital stay (4.4 ± 3.5 vs 5.4 ± 4.7 days, p <0.001). In-hospital mortality was lower for the early PCI group than for the delayed PCI group (2.7% vs 6.2%, p <0.001; entire cohort 5.7%). Comparison of patients matched on propensity score (n = 993) showed that mortality was lower in the early than in the delayed PCI group (2.6% vs 4.6%, p = 0.014, c-statistic 0.67). In conclusion, <4% of patients who received PCI were treated within the recommended guideline of <120 minutes by the American College of Cardiology/American Heart Association. Door-to-balloon times <2 hours in patients who undergo transfer for PCI is associated with a significant decrease in short-term mortality, which suggests that efforts must be made to decrease transfer delays.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>16253587</pmid><doi>10.1016/j.amjcard.2005.06.061</doi><tpages>6</tpages></addata></record> |
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| subjects | Angioplasty, Balloon, Coronary Biological and medical sciences Cardiology. Vascular system Clinical outcomes Coronary heart disease Electrocardiography Female Follow-Up Studies Heart Heart attacks Hospital Mortality - trends Hospitalization Humans Male Medical sciences Medical treatment Middle Aged Myocardial Infarction - mortality Myocardial Infarction - physiopathology Myocardial Infarction - therapy Myocarditis. Cardiomyopathies Patient admissions Patient Transfer Prognosis Registries Retrospective Studies Risk Factors Time Factors Treatment Outcome United States |
| title | Outcome in Patients Transferred for Percutaneous Coronary Intervention (A National Registry of Myocardial Infarction 2/3/4 Analysis) |
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