PMID- 18060610
OWN - NLM
STAT- MEDLINE
DCOM- 20080212
LR  - 20091103
IS  - 0340-9937 (Print)
IS  - 0340-9937 (Linking)
VI  - 32
IP  - 8
DP  - 2007 Dec
TI  - [Treatment of acute ST Elevation myocardial infarction in a regional network 
      ("Drip & Ship Network Rostock")].
PG  - 635-40
AB  - Management of acute ST elevation myocardial infarction (STEMI) demands rapid and 
      complete reperfusion of the infarct-related artery (IRA). With postinfarction 
      prognosis depending on time delay from onset of symptoms to complete reperfusion 
      (TIMI 3 flow) of the IRA, primary percutaneous coronary intervention (PPCI) 
      performed by an experienced team has been shown to be superior to thrombolytic 
      therapy with lower mortality, less frequent occurrence of nonfatal reinfarction 
      and stroke, and thus represents the preferred treatment strategy according to the 
      national and international guidelines. For regional implementation of PPCI, 
      particularly in rural areas, information and transfer logistics within networks 
      of care and direct transport of an infarction patient to a PCI hospital rather 
      than to the closest hospital are a challenge. With successful implementation of 
      network logistics and standardized therapeutic pathways, current guidelines and 
      requested timelines versus thrombolysis could be met. The implemented logistics 
      comprised 24 h/7 days stand-by services of an experienced PCI team, direct 
      telephone hotline contact between rescue service/emergency physician and 
      interventional cardiologist on call, and direct open access to a catheterization 
      laboratory at any time. Within the Drip&Ship network Rostock, to date (July 2007) 
      1,022 consecutive patients with PCI for STEMI were documented and analyzed over 5 
      years; of these, 490 patients were transferred from a community hospital to the 
      PCI center and 532 patients were admitted directly to the interventional center. 
      In 95.1% of all transferred and in 94.8% of all directly admitted patients, PCI 
      was successfully accomplished upon arrival. A normalized flow to the IRA after 
      PCI was documented in 96% of both groups, no patient was subjected to 
      thrombolytic therapy. At 12-month follow-up, there were no differences between 
      both groups with respect to infarct size and mortality. Moreover, there was no 
      evidence of differences in left ventricular ejection fraction between groups. 
      Thus, transportation of STEMI patients within an established PCI network did not 
      result in any prognostic disadvantage. Efficient network logistics with 
      transportation for PPCI in acute STEMI ensure both safety and outcome profiles 
      similar to patients treated by PCI in metropolitan areas.
FAU - Schneider, Henrik
AU  - Schneider H
FAU - Ince, Huseyin
AU  - Ince H
FAU - Rehders, Tim
AU  - Rehders T
FAU - Korber, Thomas
AU  - Korber T
FAU - Weber, Frank
AU  - Weber F
FAU - Kische, Stephan
AU  - Kische S
FAU - Chatterjee, Tuchaar
AU  - Chatterjee T
FAU - Nienaber, Christoph A
AU  - Nienaber CA
CN  - Drip&Ship-Netzwerk (District of Rostock Infarct Project & Shipping Patients)
LA  - ger
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Behandlung des akuten ST-Hebungsinfarkts in Netzwerkstrukturen: "Drip&Ship -- das 
      Rostocker Infarktmodell".
PL  - Germany
TA  - Herz
JT  - Herz
JID - 7801231
SB  - IM
MH  - *Atherectomy
MH  - Cardiology/*organization & administration
MH  - Community Networks/*organization & administration
MH  - Critical Pathways/organization & administration
MH  - *Decision Support Systems, Clinical
MH  - Delivery of Health Care/organization & administration
MH  - Delivery of Health Care, Integrated/organization & administration
MH  - Germany
MH  - Humans
MH  - Models, Organizational
MH  - Myocardial Infarction/*therapy
MH  - Regional Health Planning/*organization & administration
MH  - *Thrombolytic Therapy
RF  - 19
EDAT- 2007/12/07 09:00
MHDA- 2008/02/13 09:00
CRDT- 2007/12/07 09:00
PHST- 2007/12/07 09:00 [pubmed]
PHST- 2008/02/13 09:00 [medline]
PHST- 2007/12/07 09:00 [entrez]
AID - 10.1007/s00059-007-3061-5 [doi]
PST - ppublish
SO  - Herz. 2007 Dec;32(8):635-40. doi: 10.1007/s00059-007-3061-5.