Document Detail


Reduction of delays in primary percutaneous coronary intervention.
MedLine Citation:
PMID:  21641175     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute myocardial infarction is a major health issue. Primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction was proved to be superior to fibrinolytic therapy in many randomized trials when done in a timely manner. However, PPCI is associated with delays. Studies have shown that greater delay is associated with increased mortality rate. We applied simple interventions to reduce door-to-balloon time. Our study goal was to evaluate the reduction of delays after our interventions and to monitor 30-day mortality.
METHODS: A prospective registry was created to evaluate delays and mortality associated with PPCI. Measures such as annual feedback with suggestions were taken to minimize the delays. Door-to-balloon delays before and after the interventions were compared.
RESULTS: A total of 1361 primary PCIs were performed from 2005 to 2008. Of these cases, 1071 patients were transferred from community hospitals. The median door-to-balloon time for transferred patients was 142 minutes for 2005, 138 minutes for 2006, 125 minutes for 2007, and 121 minutes for 2008 (P < 0.001 for 2005 vs. 2008). Door-to-balloon time for patients admitted directly to our centre was 87 minutes in 2005, 74.5 minutes in 2006, 73.5 minutes in 2007, and 74.0 minutes in 2008 (P < 0.001 for 2005 vs. 2008). Thirty-day mortality of these consecutive patients is low (5.2% for 2005 and 3.8% for 2008; P = not significant).
CONCLUSIONS: Inexpensive and simple interventions may significantly reduce primary PCI-related delays for transferred cases and patients admitted directly to a centre with PPCI facilities. We also observed a low mortality rate for those consecutive patients.
Authors:
Benoit Daneault; Doan Hoa Do; Andrée Maltais; Simon Bérubé; Richard Harvey; André Gervais; Karl Dalery; Michel Nguyen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  27     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-10-03     Completed Date:  2011-12-13     Revised Date:  2012-02-28    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  562-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, Sherbrooke University, Sherbrooke, Québec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Balloon, Coronary*
Female
Humans
Male
Middle Aged
Myocardial Infarction / mortality*,  therapy*
Patient Transfer
Registries*
Time Factors
Treatment Outcome

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


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