Trends in treatment delays for patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention
Treatment delay is an important prognostic factor for patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to determine recent trends in these delays and factors associated with longer delays. We compared two datasets...
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| Veröffentlicht in: | BMC cardiovascular disorders 2014-09, Vol.14 (1), p.115-115, Article 115 |
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| creator | Helve, Salla Viikilä, Juho Laine, Mika Lilleberg, Jyrki Tierala, Ilkka Nieminen, Tuomo |
| description | Treatment delay is an important prognostic factor for patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to determine recent trends in these delays and factors associated with longer delays.
We compared two datasets collected in Helsinki University Central Hospital in 2007-2008 (HUS-STEMI I) and 2011-2012 (HUS-STEMI II), a total of 500 patients treated with primary PCI within 12 hours of the onset of symptoms.
Delays of the emergency medical system (EMS) were longer in HUS-STEMI I than II (medians 81 vs. 67 min, respectively, p < 0.001). Although door-to-balloon times were longer in the later dataset (33 vs. 48 min, p < 0.001) most of the patients (75.3% vs. 62.8%, respectively, p = 0.010) were treated within the recommendation ( |
| doi_str_mv | 10.1186/1471-2261-14-115 |
| format | Article |
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We compared two datasets collected in Helsinki University Central Hospital in 2007-2008 (HUS-STEMI I) and 2011-2012 (HUS-STEMI II), a total of 500 patients treated with primary PCI within 12 hours of the onset of symptoms.
Delays of the emergency medical system (EMS) were longer in HUS-STEMI I than II (medians 81 vs. 67 min, respectively, p < 0.001). Although door-to-balloon times were longer in the later dataset (33 vs. 48 min, p < 0.001) most of the patients (75.3% vs. 62.8%, respectively, p = 0.010) were treated within the recommendation (<60 min) of the European Society of Cardiology (ESC). In HUS-STEMI II, patient arrival at the hospital during off-hours was associated with longer door-to-balloon time (40 and 57.5 min, p = 0.001) and system delay (111 and 127 min, p = 0.009). However, in HUS-STEMI I, arrival time did not impact the delays. Longer system delay was associated with higher mortality rates.
Though the delays inside the hospital have increased they are still mostly within the ESC guidelines. Still, only about half of the patients are treated within a system delay of recommended two hours. Albeit our results are good in comparison with previous studies, further efforts for decreasing the delays particularly within the EMS should be established.</description><identifier>ISSN: 1471-2261</identifier><identifier>EISSN: 1471-2261</identifier><identifier>DOI: 10.1186/1471-2261-14-115</identifier><identifier>PMID: 25204401</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>After-Hours Care - trends ; Aged ; Cardiology ; Comparative analysis ; Drug therapy ; Emergency medical services ; Emergency Medical Services - trends ; Female ; Finland ; Guideline Adherence ; Health Services Accessibility - trends ; Heart attacks ; Hospitals, University - trends ; Humans ; Internal medicine ; Male ; Middle Aged ; Mortality ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Patients ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - mortality ; Percutaneous Coronary Intervention - trends ; Practice Guidelines as Topic ; Practice Patterns, Physicians' - trends ; Registries ; Risk Factors ; Studies ; Time Factors ; Time-to-Treatment - trends ; Treatment Outcome ; Trends</subject><ispartof>BMC cardiovascular disorders, 2014-09, Vol.14 (1), p.115-115, Article 115</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Helve et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Helve et al.; licensee BioMed Central Ltd. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b551t-ab0909daa285b4d55d6c265efe89017d18890ee507573eebbf48618b56bcd9b3</citedby><cites>FETCH-LOGICAL-b551t-ab0909daa285b4d55d6c265efe89017d18890ee507573eebbf48618b56bcd9b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168205/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168205/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,27931,27932,53798,53800</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25204401$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Helve, Salla</creatorcontrib><creatorcontrib>Viikilä, Juho</creatorcontrib><creatorcontrib>Laine, Mika</creatorcontrib><creatorcontrib>Lilleberg, Jyrki</creatorcontrib><creatorcontrib>Tierala, Ilkka</creatorcontrib><creatorcontrib>Nieminen, Tuomo</creatorcontrib><title>Trends in treatment delays for patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention</title><title>BMC cardiovascular disorders</title><addtitle>BMC Cardiovasc Disord</addtitle><description>Treatment delay is an important prognostic factor for patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to determine recent trends in these delays and factors associated with longer delays.
We compared two datasets collected in Helsinki University Central Hospital in 2007-2008 (HUS-STEMI I) and 2011-2012 (HUS-STEMI II), a total of 500 patients treated with primary PCI within 12 hours of the onset of symptoms.
Delays of the emergency medical system (EMS) were longer in HUS-STEMI I than II (medians 81 vs. 67 min, respectively, p < 0.001). Although door-to-balloon times were longer in the later dataset (33 vs. 48 min, p < 0.001) most of the patients (75.3% vs. 62.8%, respectively, p = 0.010) were treated within the recommendation (<60 min) of the European Society of Cardiology (ESC). In HUS-STEMI II, patient arrival at the hospital during off-hours was associated with longer door-to-balloon time (40 and 57.5 min, p = 0.001) and system delay (111 and 127 min, p = 0.009). However, in HUS-STEMI I, arrival time did not impact the delays. Longer system delay was associated with higher mortality rates.
Though the delays inside the hospital have increased they are still mostly within the ESC guidelines. Still, only about half of the patients are treated within a system delay of recommended two hours. Albeit our results are good in comparison with previous studies, further efforts for decreasing the delays particularly within the EMS should be established.</description><subject>After-Hours Care - trends</subject><subject>Aged</subject><subject>Cardiology</subject><subject>Comparative analysis</subject><subject>Drug therapy</subject><subject>Emergency medical services</subject><subject>Emergency Medical Services - trends</subject><subject>Female</subject><subject>Finland</subject><subject>Guideline Adherence</subject><subject>Health Services Accessibility - trends</subject><subject>Heart attacks</subject><subject>Hospitals, University - trends</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - mortality</subject><subject>Percutaneous Coronary Intervention - trends</subject><subject>Practice Guidelines as Topic</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Registries</subject><subject>Risk Factors</subject><subject>Studies</subject><subject>Time Factors</subject><subject>Time-to-Treatment - trends</subject><subject>Treatment Outcome</subject><subject>Trends</subject><issn>1471-2261</issn><issn>1471-2261</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1Ustu1DAUjRCIlsKeFbLEhk2KncROskGqRrykSl109pYfN62rxB7sZNB8BP_MTTMMnaqVF7bOPefcl7PsPaPnjDXiM6tqlheFYDmrcsb4i-z0AL188D7J3qR0RymrG9q-zk4KXtCqouw0-7OO4G0izpMxghoH8COx0KtdIl2IZKNGh1Aiv914S5SZRiDX6xx62GIkeDLsglHROtWjR6eiuUfvvcAuqk10g4o7soGIeuUhTImYEIOfUedHiFvMgbq32atO9Qne7e-zbP3t63r1I7-8-v5zdXGZa87ZmCtNW9papYqG68pyboUpBIcOmhZ7tKzBG4DTmtclgNZd1QjWaC60sa0uz7Ivi-1m0gNYg8mj6uW-ThmUk8cR727lTdjKiommoBwNVouBduEZg-OICYOctyHnbeBL4rLQ5dO-jBh-TZBGObhkoO-XEUnGRUkFLcsGqR8fUe_CFD3OaGbhOouaFf9ZN6oHiesImNzMpvKCly2vsYSZdf4EC4-FwZngoXOIHwnoIjAxpBShOzTKqJz_4VOtfXg44YPg38cr_wJRO9vQ</recordid><startdate>20140910</startdate><enddate>20140910</enddate><creator>Helve, Salla</creator><creator>Viikilä, Juho</creator><creator>Laine, Mika</creator><creator>Lilleberg, Jyrki</creator><creator>Tierala, Ilkka</creator><creator>Nieminen, Tuomo</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140910</creationdate><title>Trends in treatment delays for patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention</title><author>Helve, Salla ; 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We aimed to determine recent trends in these delays and factors associated with longer delays.
We compared two datasets collected in Helsinki University Central Hospital in 2007-2008 (HUS-STEMI I) and 2011-2012 (HUS-STEMI II), a total of 500 patients treated with primary PCI within 12 hours of the onset of symptoms.
Delays of the emergency medical system (EMS) were longer in HUS-STEMI I than II (medians 81 vs. 67 min, respectively, p < 0.001). Although door-to-balloon times were longer in the later dataset (33 vs. 48 min, p < 0.001) most of the patients (75.3% vs. 62.8%, respectively, p = 0.010) were treated within the recommendation (<60 min) of the European Society of Cardiology (ESC). In HUS-STEMI II, patient arrival at the hospital during off-hours was associated with longer door-to-balloon time (40 and 57.5 min, p = 0.001) and system delay (111 and 127 min, p = 0.009). However, in HUS-STEMI I, arrival time did not impact the delays. Longer system delay was associated with higher mortality rates.
Though the delays inside the hospital have increased they are still mostly within the ESC guidelines. Still, only about half of the patients are treated within a system delay of recommended two hours. Albeit our results are good in comparison with previous studies, further efforts for decreasing the delays particularly within the EMS should be established.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25204401</pmid><doi>10.1186/1471-2261-14-115</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | After-Hours Care - trends Aged Cardiology Comparative analysis Drug therapy Emergency medical services Emergency Medical Services - trends Female Finland Guideline Adherence Health Services Accessibility - trends Heart attacks Hospitals, University - trends Humans Internal medicine Male Middle Aged Mortality Myocardial Infarction - diagnosis Myocardial Infarction - mortality Myocardial Infarction - therapy Patients Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - mortality Percutaneous Coronary Intervention - trends Practice Guidelines as Topic Practice Patterns, Physicians' - trends Registries Risk Factors Studies Time Factors Time-to-Treatment - trends Treatment Outcome Trends |
| title | Trends in treatment delays for patients with acute ST-elevation myocardial infarction treated with primary percutaneous coronary intervention |
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