The Chain of Survival for ST-Segment Elevation Myocardial Infarction

Abstract

Although coronary heart disease is the leading cause of morbidity and mortality in the Middle East (ME), not much is known about patients with ST-segment elevation myocardial infarction (STEMI) from this region. The STEMI Chain of Survival can be used to target regional improvements in patient care. We tried to adopt a modified chain of survival for STEMI to highlight the challenges and difficulties and the possible solutions to improve the STEMI care in the Middle East based on the few data available.

International facets of the ‘chain of survival’ for out-of-hospital and in-hospital cardiac arrest – A scoping review

“…Mere adaptations of the existing chain (mostly expansions of the chain) included extensions specific for survival after ventricular fibrillation (focusing on secondary prevention), 39 for rehabilitation, 27 general prevention, 42 or family support. 15 Also, there were suggestions of making the chain into a circle, 24 a more detailed description of the chain for ST-elevation myocardial infarction, 36 a variation of the chainmail of survival to low-resource settings, 44 a depiction of survival odds along the chain and associated research funding, 25 and a chain with a visual adaptation of the size of each link reflecting their relative contribution to survival. 26 …”

“…After data extraction, the reviewers met and reached a consensus on how to categorize the ideas within the articles included. We thus sorted the publication types into subgroups that were most suitable and internationally recognized (even though a specific journal may have classified a publication differently, e.g., “special report”), and thus report on four abstracts, 13 , 14 , 15 , 16 two commentaries, 17 , 18 five editorials, 19 , 20 , 21 , 22 , 23 ten letters, 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 five concepts, 34 , 35 , 36 , 37 , 38 three reviews, 39 , 40 , 41 four statements, 1 , 42 , 43 , 44 six reports of original research, 45 , 46 , 47 , 48 , 49 , 50 and four guidelines. 4 , 51 , 52 , 53 We further grouped the publications ( Supplementary Table S1 ) into “novel kinds of the concept related to resuscitation” ( n = 8), 1 , 4 , 18 , 30 , 31 , 32 , 49 , 51 “novel kinds of the concept not directly related to resuscitation” ( n = 23), 14 , 16 , 17 , 19 , 20 , …”

Optimizing an Emergency Medical Dispatch System to Improve Prehospital Diagnosis and Treatment of Acute Coronary Syndrome: Nationwide Retrospective Study in China

“…Though the outcome data could not be obtained and analyzed in this study, the onset-to-call time was still near 1 hour; thus, the optimized MPDS could hardly predict improved in-hospital mortality. For time-concerning emergencies such as ACS, the first link of the chain of survival would always be early symptom recognition and seeking for EMS by the public [25][26][27]. Any subsequent treatment will not be effective without timely activation of this first link.…”