Author + information
- Sa'ar Minha,
- Joshua Loh,
- Lowell Satler,
- Israel Barbash,
- Danny Dvir,
- Itsik Ben-Dor,
- Salem Badr,
- Lakshmana Pendyala,
- Hironori Kitabata,
- Kenneth Kent,
- Augusto Pichard,
- William Suddath,
- Rebecca Torguson and
- Ron Waksman
Delays in transfer of ST-elevation patients to primary percutaneous intervention (PPCI) is associated with poor outcome. The purpose of this study was to explore the effect of transfer distance on time interval delays and outcomes of patients transferred for PPCI.
A cohort of 1066 transferred patients was divided into two groups by transfer distance: greater than (GT) 25 miles (n=609, 57.12%) and less than (LT) 25 miles (n=457, 42.88%). A comparison of characteristics, outcome and time delays to PPCI was performed.
The two groups were well balanced in terms of age, risk factors and ejection fraction, except for a higher rate of men in the GT group (p=0.032). The average door-to-balloon time was similar (220.70±281.17(GT) vs. 213.89±213.82 (LT), p=0.674). The delay (minutes) in the time from first call to interventionalist to arrival at the catheterization lab was longer in the GT group (84.86±136.76 vs. 64.51±28.92, p=0.002), while the time delay from presentation to the emergency room to electrocardiogram (ECG) was longer in the LT group (51.21±196.21 vs. 27.55±97.66, p=0.019). (Table) The outcomes at 1 year did not differ between groups.
Patients transferred from long distances benefit from collaborative efforts to decrease the time delay to PPCI and share similar outcomes as those transferred from shorter distances. Emergency departments should endorse triage programs aimed at decreasing the delay from presentation to ECG.
|Variable||Transfer Distance >25 miles (n=609)||Transfer Distance <25 miles (n=457)||p value|
|Time Interval (min±SD)|
|Symptom to ER||462.04±1222.33||580.79±1573.12||0.241|
|ER to ECG||27.55±97.67||51.21±169.21||0.019|
|ECG to first call||71.44±204.71||83.66±197.41||0.401|
|First call to cath lab arrival||84.86±136.76||65.41±28.92||0.002|
|Cath lab arrival to balloon||38.94±18.76||40.26±39.87||0.513|
|Door to balloon||220.70±281.17||213.89±213.82||0.674|
|MACE (TVR, MI and death)||21.9%||26.5%||0.235|
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pre-Hospital ECG and Transfer: Time Is Myocardium
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1212-194
- 2013 American College of Cardiology Foundation