Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study

Nozari, Younes; Geraiely, Babak; Alipasandi, Kian; Jalali, Arash; Omidi, Negar; Aghajani, Hassan; Haji-Zeinali, Ali-Mohammad; Alidoosti, Mohammad; Pourhoseini, Hamidreza; Salarifar, Mojtaba; Amirzadegan, Alireza; Nematipour, Ebrahim; Nomali, Mahin

doi:10.2196/13161

Cited by 5 publications

(11 citation statements)

References 33 publications

(36 reference statements)

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“…We conducted an observational study according to the 24/7 primary PCI service registry of THC in Iran. Details of the study design and setting have been published previously [ 26 ]. The study protocol was approved by the institutional review board and research ethics committee of Tehran University of Medical Sciences.…”

Section: Methodsmentioning

confidence: 99%

“…Inclusion criteria for this study were age older than 18 years, confirmed diagnosis of STEMI, and primary PCI through a standard technique without bolus administration of fibrinolytic agents in the catheterization laboratory of THC. Those with incomplete data regarding one of the time to treatment variables (eg, symptom-to-door time, door-to-balloon time, and symptom-to-balloon time) and the study outcome (ie, in-hospital MACCEs) were excluded from the analysis [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…We used the registered data in the 24/7 primary PCI service registry as the main source of data. Details of the registry have been previously published [ 26 ]. Collected data from the time of admission to the emergency department (ED) to transfer to the catheterization laboratory through the STEMI management registry form were entered in the 24/7 primary PCI service registry by research staff weekly [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…Details of the registry have been previously published [ 26 ]. Collected data from the time of admission to the emergency department (ED) to transfer to the catheterization laboratory through the STEMI management registry form were entered in the 24/7 primary PCI service registry by research staff weekly [ 26 ]. A flow chart of patient admission to the ED and transfer to the catheterization laboratory of THC has been published previously [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

“…We explained study variables in the study protocol completely [ 26 ]. Demographic and clinical variables were recorded.…”

Section: Methodsmentioning

confidence: 99%

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Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Cross-Sectional Study

et al. 2020

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Background Performing primary percutaneous coronary intervention (PCI) as a preferred reperfusion strategy for patients with ST-segment elevation myocardial infarction (STEMI) may be associated with major adverse cardiocerebrovascular events (MACCEs). Thus, timely primary PCI has been emphasized in order to improve outcomes. Despite guideline recommendations on trying to reduce the door-to-balloon time to <90 minutes in order to reduce mortality, less attention has been paid to other components of time to treatment, such as the symptom-to-balloon time, as an indicator of the total ischemic time, which includes the symptom-to-door time and door-to-balloon time, in terms of clinical outcomes of patients with STEMI undergoing primary PCI. Objective We aimed to determine the association between each component of time to treatment (ie, symptom-to-door time, door-to-balloon time, and symptom-to-balloon time) and in-hospital MACCEs among patients with STEMI who underwent primary PCI. Methods In this observational study, according to a prospective primary PCI 24/7 service registry, adult patients with STEMI who underwent primary PCI in one of six catheterization laboratories of Tehran Heart Center from November 2015 to August 2019, were studied. The primary outcome was in-hospital MACCEs, which was a composite index consisting of cardiac death, revascularization (ie, target vessel revascularization/target lesion revascularization), myocardial infarction, and stroke. It was compared at different levels of time to treatment (ie, symptom-to-door and door-to-balloon time <90 and ≥90 minutes, and symptom-to-balloon time <180 and ≥180 minutes). Data were analyzed using SPSS software version 24 (IBM Corp), with descriptive statistics, such as frequency, percentage, mean, and standard deviation, and statistical tests, such as chi-square test, t test, and univariate and multivariate logistic regression analyses, and with a significance level of <.05 and 95% CIs for odds ratios (ORs). Results Data from 2823 out of 3204 patients were analyzed (mean age of 59.6 years, SD 11.6 years; 79.5% male [n=2243]; completion rate: 88.1%). Low proportions of symptom-to-door time ≤90 minutes and symptom-to-balloon time ≤180 minutes were observed among the study patients (579/2823, 20.5% and 691/2823, 24.5%, respectively). Overall, 2.4% (69/2823) of the patients experienced in-hospital MACCEs, and cardiac death (45/2823, 1.6%) was the most common cardiac outcome. In the univariate analysis, the symptom-to-balloon time predicted in-hospital MACCEs (OR 2.2, 95% CI 1.1-4.4; P=.03), while the symptom-to-door time (OR 1.4, 95% CI 0.7-2.6; P=.34) and door-to-balloon time (OR 1.1, 95% CI 0.6-1.8, P=.77) were not associated with in-hospital MACCEs. In the multivariate analysis, only symptom-to-balloon time ≥180 minutes was associated with in-hospital MACCEs and was a predictor of in-hospital MACCEs (OR 2.3, 95% CI 1.1-5.2; P=.04). Conclusions A longer symptom-to-balloon time was the only component associated with higher in-hospital MACCEs in the present study. Efforts should be made to shorten the symptom-to-balloon time in order to improve in-hospital MACCEs. International Registered Report Identifier (IRRID) RR2-10.2196/13161

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…We explained study variables in the study protocol completely [ 26 ]. Demographic and clinical variables were recorded.…”

Section: Methodsmentioning

confidence: 99%

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Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Cross-Sectional Study

et al. 2020

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Research Progress on the Correlation between Blood Lactate Level and Major Adverse Cardiovascular Events after PCI of Acute Myocardial Infarction

艾

2023

ACM

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Myocardial Infarction in Iran: Epidemiology, Management, and Prognosis

Beyranvand,

Manhoobi,

Shahraz

et al. 2023

JTHC

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Background: Cardiovascular diseases, specifically acute myocardial infarction (AMI), are the leading cause of death worldwide. In this review, we explain the characteristics of AMI in Iran. Methods: We searched PubMed, Google, and Google Scholar for articles containing myocardial infarction, STEMI, and MI+ Iran in English and Persian words. Results: The age-standardized incidence rate of MI was 73.3 per 100 000. The mean±SD age of patients was 61.20±13.40 years. In-hospital mortality of patients with AMI in the IMIR was 12.1%. Concerning AMI complications reported in the IMIR, 5.8% of patients experienced ventricular tachycardia, and 2.5% experienced ventricular fibrillation. The 1-year mortality rate in the IPACE2 study was 4.3%. Conclusion: Only a few national studies are available in Iran regarding patients with AMI. A federal surveillance program continuously monitoring and tracking coronary events is essential to improve the general population’s health.

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Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study

Cited by 5 publications

References 33 publications

Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Cross-Sectional Study

Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Cross-Sectional Study

Research Progress on the Correlation between Blood Lactate Level and Major Adverse Cardiovascular Events after PCI of Acute Myocardial Infarction

Myocardial Infarction in Iran: Epidemiology, Management, and Prognosis

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