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Primary percutaneous transluminal coronary angioplasty (PTCA) is the treatment of choice in treating acute ST elevation myocardial infarction (STEMI), and shorter door-to-balloon time is associated with lower mortality. The question remains: will performing primary PTCA within the Emergency Department (ED) further reduce door to balloon time and affect mortality?
1020 patients admitted to a community hospital between 4/1998 to 12/2011 with STEMI and treated with primary PTCA were prospectively reviewed. Of the 1020 patients, 534 (52%) were taken to the ED cath lab (ED) and 486 (48%) were taken to the inpatient cath lab (ICL). The protocol for initiating “Cardiac Care” and contacting the on-call interventional cardiologist and cath lab team was the same for both groups.
The mean age of the ED and ICL groups were similar (60 vs 59). There was no significant difference in percent of patients presenting with LV dysfunction (7 vs 9%, p 0.4). The median door to balloon time was 53 minutes (range 6–214) with a mean of 56 minutes in the ED group, while those in the ICL group had a median time of 83 minutes (17–252) with an average of 85 minutes. One-year mortality for the ED group was 2% (25 patients) and 6% (31 patients) for the ICL group.
Primary PTCA performed within the ED cath lab can reduce door to balloon time and positively affect STEMI mortality.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: ACS Therapy
Abstract Category: 3. Acute Coronary Syndromes: Therapy
Presentation Number: 1255M-174
- 2013 American College of Cardiology Foundation