Comparing Door-To-Balloon Time between ST-Elevation Myocardial Infarction Electrocardiogram and Its Equivalents

Choi, Yoonsuk; Kim, Kiwook; Oh, Joo Suk; Jeong, Hyun Ho; Park, Jung Taek; Kyong, Yeon Young; Oh, Yonghwan; Choi, Se Joon; Choi, Kyoung Ho

doi:10.3390/jcm11195547

Cited by 3 publications

(1 citation statement)

References 45 publications

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“…Though findings showed a delay in PCI for about one-quarter of patients, shorter door-to-balloon intervals showed that the emergency response was quite good. It is pertinent to mention that for patients who need PCI, the door-to-balloon interval is considered a crucial time because the shorter door-to-balloon interval is associated with significantly reduced morbidity and mortality in ACS patients [ 47 , 48 ]. The results of the current study further showed that about 85% of the eligible patients were referred to cardiac rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Exploring Clinical Trajectories and the Continuum of Care for Patients With Acute Coronary Syndrome in the United Kingdom: A Thorough Cross-Sectional Analysis

Zaki,

Bashir,

Mahdy

et al. 2023

Cureus

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The United Kingdom (UK) has a sustainable healthcare system. Nonetheless, the burden of acute coronary syndrome (ACS) is still a significant challenge. A scarcity of literature primarily focuses on the continuum of care for ACS patients in the UK. Moreover, limited research studies highlight the clinical trajectories of ACS patients across the UK. Therefore, the current study was designed to explore clinical trajectories and the continuum of care for patients with ACS in the UK. Secondary data was obtained from the Myocardial Ischaemia National Audit Project (MINAP) database. The latest data available in the MINAP database was used. As our objective was to explore clinical trajectories and the continuum of care for patients, we retrieved data regarding the care received by ACS patients admitted to hospitals across the UK. The data of 85574 ACS patients was retrieved. A large number (n=47035) of patients were estimated to be eligible for the angiogram; however, an angiogram was performed for 87.15% (n=40995) of eligible patients. Angioplasty within 72 hours of admission was required for most (n=26313) ACS patients. Nonetheless, angioplasty within 72 hours of admission was performed for 59.7% (n=15703) of the eligible patients. There was a significant difference (P<0.05) between different regions of the UK and the percentage of patients for whom angioplasty was performed within 72 hours of admission. Primary percutaneous coronary intervention (PCI) was performed for 23923 ACS patients, of which the door-to-balloon interval for 17590 (73.5%) patients was ≤60 minutes while the door-to-balloon interval for 3086 (12.9%) patients was ≤90 minutes. Out of the total 85574 ACS patients, 65959 (77.08%) patients were discharged on appropriate medications, while 19615 (22.92%) were transferred to another hospital or died there. A total of 75361 were eligible to be referred to cardiac rehabilitation settings. Nonetheless, 64518 (85.61%) were referred to cardiac rehabilitation. About 85000 patients were reported in the UK (England, Northern Ireland, Wales). Optimal care was provided to most patients in the UK. However, some patients received sub-optimal care, highlighting the disparity in the healthcare system. There is a need to explore further the factors that might be responsible for the sub-optimal care to the patients.

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Section: Discussionmentioning

confidence: 99%

Exploring Clinical Trajectories and the Continuum of Care for Patients With Acute Coronary Syndrome in the United Kingdom: A Thorough Cross-Sectional Analysis

Zaki,

Bashir,

Mahdy

et al. 2023

Cureus

View full text Add to dashboard Cite

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Factors Influencing Late Prognosis in Patients With Acute St-Segment Elevation Myocardial Infarction Treated With Direct Percutaneous Coronary Intervention

Li,

Cao

2024

Shock

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Objective Investigating factors influencing the late prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) treated by direct percutaneous coronary intervention (PCI). Methods We retrospectively analyzed 349 STEMI patients treated with direct PCI. Patients were categorized based on catheter lab activation time (CLAT) (≤15 min or > 15 min), time of arrival (working-hours or out-of-hours), and mode of arrival (EMS transportation or self-presentation). The primary endpoint was the 2-year major adverse cardiovascular events (MACE), defined as all-cause death, nonfatal myocardial infarction, and target vessel revascularization. Results Patients with CLAT ≤15 minutes showed significant differences in oxygen saturation, FMC-to-device time, symptom-to-device time, symptom-to-FMC time, presentation mode, presentation duration, and MACE (all P < 0.005). Self-presentation (OR = 0.593, 95%CI: 0.413–0.759) and out-of-hours presentation (OR = 0.612, 95%CI: 0.433–0.813) were risk factors for CLAT >15 min. The working-hours group showed significant differences in FMC-to-device time, activation-to-arrival time at the catheter lab, and the number of cases with activation time ≤ 15 min (all P < 0.005). The EMS and self-presentation groups differed significantly in age, blood pressure, FMC-to-device time, and ECG-to-CLAT (all P < 0.005). Conclusion Reducing CLAT to 15 minutes significantly lowers the 2-year MACE rate. Self-presentation and out-of-hours presentation are risk factors for delayed catheter lab activation.

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Reducing door-to-balloon time in STEMI patients through instant messaging: An empirical study during the COVID-19 pandemic

Yang,

Liu,

2024

Tungs’ Med J

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Background: Percutaneous coronary intervention (PCI) is the preferred treatment for ST-segment elevation myocardial infarction (STEMI). Guidelines recommend maintaining the door-to-balloon time (DTBT) within 90 min to improve treatment outcomes and minimize complications. However, the coronavirus disease 2019 pandemic has posed additional challenges for the healthcare systems. Objectives: This study aims to evaluate the impact of the LINE instant messaging system on DTBT in STEMI patients, focusing on its role in improving communication between emergency department physicians and catheterization lab personnel. Methods: This retrospective study analyzed data from STEMI patients hospitalized in a regional hospital in central Taiwan. Patients were categorized into a control group (2020–2021, standard care) and an experimental group (2022–2023, care enhanced with LINE instant messaging). Medical records were retrospectively reviewed and analyzed. Results: A total of 269 STEMI patients were included (experimental group: 129 and control group: 140). The proportion of patients achieving door-to-electrocardiogram time (DTET) ≤10 min was similar in the two groups (experimental: 92.2% and control: 93.6%; P = 0.674). Similarly, there was no significant difference in DTBT ≤90 min (experimental: 78.9% and control: 78.6%; P = 0.956) or discharge outcomes (experimental: 3.1% and control: 2.1%; P = 0.624). Conclusion: DTBT ≤90 min was positively correlated with DTET ≤10 min (r = 0.244, P < 0.01) and door-to-catheter room time (DTCT; r = 0.461, P < 0.01). The use of LINE instant messaging streamlined emergency room communication and reduced inefficiencies, but uncontrollable factors during the pandemic continued to affect PCI times. This study highlights the potential of instant messaging to improve DTBT in STEMI patients.

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Comparing Door-To-Balloon Time between ST-Elevation Myocardial Infarction Electrocardiogram and Its Equivalents

Cited by 3 publications

References 45 publications

Exploring Clinical Trajectories and the Continuum of Care for Patients With Acute Coronary Syndrome in the United Kingdom: A Thorough Cross-Sectional Analysis

Exploring Clinical Trajectories and the Continuum of Care for Patients With Acute Coronary Syndrome in the United Kingdom: A Thorough Cross-Sectional Analysis

Factors Influencing Late Prognosis in Patients With Acute St-Segment Elevation Myocardial Infarction Treated With Direct Percutaneous Coronary Intervention

Reducing door-to-balloon time in STEMI patients through instant messaging: An empirical study during the COVID-19 pandemic

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