Document Detail


Primary percutaneous coronary intervention in acute myocardial infarction: direct transportation to catheterization laboratory by emergency teams reduces door-to-balloon time.
MedLine Citation:
PMID:  16596833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Primary percutaneous coronary intervention (PCI) is the recommended revascularization strategy for patients presenting with acute ST-elevation myocardial infarction (STEMI). In most hospitals, transfer of patients with STEMI is organized from the emergency site via emergency room (medical and cardiologic evaluation) and then to the catheterization laboratory. HYPOTHESIS: In this prospective study, we sought to evaluate the effect of a logistic modification in this treatment process. METHODS: Local emergency ambulance teams were instructed to identify and evaluate patients with STEMI eligible for direct PCI and to transport them directly to the cardiac catheterization laboratory for immediate percutaneous coronary intervention ("ER bypass"). This study prospectively included 74 consecutive patients with acute coronary syndromes (STEMI) and compared them with a matched historic control group ("ER evaluation"). Primary endpoint was the reduction in door-to-balloon time; secondary endpoint was quality of preclinical emergency diagnosis. RESULTS: Median door-to-balloon time was reduced by 27 min. Primary interventional success was achieved in 92% of patients. Preclinical emergency diagnoses were correct in 95% of patients. CONCLUSION: The preclinical emergency diagnosis of STEMI was reliable. Direct transport of patients with STEMI to the cardiac catheterization laboratory and early preclinical alert by the interventional PCI team significantly reduces door-to-balloon-times compared with established standard processes-of-care for patients considered for primary PCI.
Authors:
Andreas van de Loo; Bernward Saurbier; Johannes Kalbhenn; Frank Koberne; Manfred Zehender
Related Documents :
23389853 - Standardized review of atrial anatomy for cardiac electrophysiologists.
11785993 - Efficacy of hirudin in reducing cardiovascular events in patients with acute coronary s...
19869053 - Physiological ontogeny : a. chicken embryos. vi. differentiation in the chicken embryo ...
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  29     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-04-06     Completed Date:  2006-07-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  112-6     Citation Subset:  IM    
Affiliation:
Universitätsklinik Freiburg, Department of Cardiology, Germany. andreasvandeloo@aol.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ambulances / standards*
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Cardiac Care Facilities
Case-Control Studies
Emergency Medical Technicians
Female
Germany
Heart Catheterization / standards*,  trends
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  mortality,  therapy*
Patient Care Team
Patient Transfer / methods*,  standards
Probability
Prospective Studies
Quality of Health Care
Reproducibility of Results
Risk Assessment
Severity of Illness Index
Survival Rate
Time and Motion Studies
Treatment Outcome
Triage*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Operating characteristics of the Finapress system to predict elevated left ventricular filling press...
Next Document:  Characteristics and outcome of octogenarian population referred for myocardial perfusion imaging: co...