PMID- 18475124
OWN - NLM
STAT- MEDLINE
DCOM- 20080926
LR  - 20121115
IS  - 1558-2027 (Print)
IS  - 1558-2027 (Linking)
VI  - 9
IP  - 6
DP  - 2008 Jun
TI  - Impact of prehospital diagnosis in the management of ST elevation myocardial 
      infarction in the era of primary percutaneous coronary intervention: reduction of 
      treatment delay and mortality.
PG  - 570-5
LID - 10.2459/JCM.0b013e3282f2c9bd [doi]
AB  - OBJECTIVES: The aim of the study is to assess, as primary endpoints, in-hospital 
      mortality and percutaneous coronary intervention (PCI) mortality and to compare 
      the outcome in ST elevation myocardial infarction (STEMI) patients with different 
      pathways to a catheterization laboratory in the context of an area with 24 h 
      availability of catheter facilities. METHODS: Three hundred and ninety-nine STEMI 
      patients, referred to an interventional centre for primary PCI, were divided into 
      two groups according to the different pathways to the catheterization laboratory. 
      Group A had 263 patients diagnosed following admission to First Aid. Group B had 
      136 patients diagnosed in a prehospital setting with telemedicine equipment and 
      transferred directly to the interventional centre by advanced life support (ALS) 
      ambulance. RESULTS: Significantly shorter treatment delay was observed in group B 
      patients than in group A (262 +/- 112 vs. 148 +/- 81 min in group A vs. B, P < 
      0.001). A significant reduction in total mortality was observed in group B 
      compared with group A (8.7 vs. 3% in group A vs. B, P < 0.05). After multivariate 
      analysis, predictors of in-hospital mortality are age and Killip class (P < 
      0.01), different pathways to catheterization laboratory, pre-PCI TIMI flow and 
      onset-to-balloon time (P < 0.05). CONCLUSION: The present study shows a reduction 
      in treatment delay and in-hospital mortality by prehospital ECG and direct 
      referral to catheterization laboratory.
FAU - Zanini, Roberto
AU  - Zanini R
AD  - Department of Cardiology, Mantova City Hospital Carlo Poma, Mantova, Italy. 
      cardiomantova@virgilio.it
FAU - Aroldi, Marco
AU  - Aroldi M
FAU - Bonatti, Silvia
AU  - Bonatti S
FAU - Buffoli, Francesca
AU  - Buffoli F
FAU - Izzo, Antonio
AU  - Izzo A
FAU - Lettieri, Corrado
AU  - Lettieri C
FAU - Romano, Michele
AU  - Romano M
FAU - Tomasi, Luca
AU  - Tomasi L
FAU - Ferrari, Maria Rosa
AU  - Ferrari MR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Med (Hagerstown)
JT  - Journal of cardiovascular medicine (Hagerstown, Md.)
JID - 101259752
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*mortality
MH  - Cardiac Catheterization
MH  - *Electrocardiography
MH  - *Emergency Medical Services
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/*diagnosis/mortality/*physiopathology
MH  - Time Factors
EDAT- 2008/05/14 09:00
MHDA- 2008/09/27 09:00
CRDT- 2008/05/14 09:00
PHST- 2008/05/14 09:00 [pubmed]
PHST- 2008/09/27 09:00 [medline]
PHST- 2008/05/14 09:00 [entrez]
AID - 01244665-200806000-00004 [pii]
AID - 10.2459/JCM.0b013e3282f2c9bd [doi]
PST - ppublish
SO  - J Cardiovasc Med (Hagerstown). 2008 Jun;9(6):570-5. doi: 
      10.2459/JCM.0b013e3282f2c9bd.