Document Detail

Primary angioplasty for any patient with ST-elevation myocardial infarction? Guideline-adherent feasibility and impact on mortality in a rural infarction network.
MedLine Citation:
PMID:  20607543     Owner:  NLM     Status:  In-Process    
AIMS: The aim of this study was to assess the guideline-adherent feasibility of area-wide primary angioplasty in rural German surroundings and its impact on reperfusion and outcome in patients with acute ST-elevation myocardial infarction (STEMI).
METHODS AND RESULTS: All consecutive patients with acute STEMI (n = 347) admitted to any of the hospitals (5 non invasive and 1 invasive with established 24 h/7 days primary angioplasty service) in a 350.000 inhabitant rural area during the year 2002 (n = 184) and 2005 (n = 163) were included in this registry. In 2002, emergency medical services transferred acute STEMI patients to the nearest emergency room, where reperfusion therapy (fibrinolysis or primary angioplasty) was organised. In 2005, all patients were transferred directly to the cathlab bypassing any emergency room when possible. Primary angioplasty increased from 53 to 89% (p < 0.01), fibrinolysis decreased from 27 to 2% (p < 0.01) and the no revascularisation rate from 21 to 9% (p < 0.01). Onset of pain to balloon time in primary angioplasty was reduced from median 339 to 191 min (p < 0.01), median first medical contact to balloon time in 2005 was 101 min. Overall, 6-month mortality decreased from 19 to 10% (p = 0.03).
CONCLUSIONS: After transition to a uniform primary angioplasty concept, an increase in overall reperfusion rates and a decrease in time delays could be observed in a rural German infarction network.
Ralf Birkemeyer; Andreas Rillig; Annette Koch; Tomislav Miljak; Markus Kunze; Udo Meyerfeldt; Wolfgang Steffen; Martin Soballa; Carsten Ranke; Roland Prassler; Albert Benzing; Werner Jung
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Publication Detail:
Type:  Journal Article     Date:  2010-07-06
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  99     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  833-40     Citation Subset:  IM    
Department of Cardiology, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Vöhrenbacherstrasse 23, 78050 Villingen-Schwenningen, Germany.
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