STEMI notification by EMS predicts shorter door-to-balloon time and smaller infarct size.

Abstract

BACKGROUND:

Emergency medical services (EMS) transportation is associated with shorter door-to-balloon (DTB) time in patients with ST-segment elevation myocardial infarction (STEMI). In addition to EMS transportation, prehospital notification of STEMI by EMS to receiving hospital might be able to further shorten DTB time. We evaluated the impact of STEMI notification on DTB time as well as infarct size.

METHODS:

We performed a retrospective analysis of consecutive patients with anterior wall STEMI who underwent emergent coronary angiography. We excluded patients who presented with cardiac arrest and those who were transferred from non-percutaneous coronary intervention-capable hospitals. Mode of transportation were categorized into the 3 groups: (1) EMS transport with STEMI notification, (2) EMS transport without STEMI notification, and (3) self-transport. Baseline characteristics, laboratory data, left ventricular ejection fraction (LVEF), and DTB time were compared among the 3 groups.

RESULTS:

A total of 148 patients were included in the final analysis. Of the 148 patients, 56 patients arrived by EMS transport with STEMI notification, 56 patients arrived by EMS transport without STEMI notification, and 36 patients arrived by self-transport. Patients who arrived by EMS transport with STEMI notification had the shortest DTB time among the 3 groups. Patients who arrived by EMS transport with STEMI notification had smaller infarct size, as indicated by lower peak creatine kinase value and higher LVEF, compared with those who arrived by EMS transport without STEMI notification.

CONCLUSION:

Emergency medical services transport with STEMI notification was associated with shorter DTB time and smaller infarct size in patients with anterior wall STEMI.

• Authors: Akihiro Kobayashi, Naoki Misumida, Shunsuke Aoi, Eric Steinberg, Kathleen Kearney, John T Fox, Yumiko Kanei
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 34 Issue 8 Pg. 1610-3 (Aug 2016) ISSN: 1532-8171 [Electronic] United States
• PMID: 27317481 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Aged
• Angioplasty, Balloon, Coronary
• Coronary Angiography
• Echocardiography
• Electrocardiography
• Emergency Medical Services (standards)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Retrospective Studies
• ST Elevation Myocardial Infarction (diagnosis, therapy)
• Severity of Illness Index
• Time Factors
• Time-to-Treatment (standards)
• Transportation of Patients (standards)