PMID- 18523608
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20110714
LR  - 20211020
IS  - 1201-026X (Print)
IS  - 1201-026X (Linking)
VI  - 10
IP  - 2
DP  - 2007 Jul
TI  - Reperfusion times for ST elevation myocardial infarction: a prospective audit.
PG  - 75-80
AB  - BACKGROUND: New published guidelines recommend treatment of ST elevation 
      myocardial infarction (STEMI) within 30 minutes of first medical contact to 
      thrombolysis and 90 minutes to primary percutaneous coronary intervention (PCI). 
      OBJECTIVES: To determine how a tertiary care center compares to these new 
      guidelines and to evaluate the success of measures directed to shorten delays. 
      METHODS: This was a prospectively designed audit loop using retrospective chart 
      review. Specific time intervals were evaluated: 1) T2 (ER presentation to 
      diagnostic EKG; 2) T ER (ER presentation to reperfusion); and 3) T AHA (first 
      medical contact to reperfusion). Results of the initial 12-month data were 
      conveyed to Emergency Room staff and a dedicated EKG machine was placed in the ER 
      for the subsequent 12 months, and the results were then re-analyzed. RESULTS: In 
      2003-4, 58 patients with STEMI were identified, with 41 (70.7%) receiving 
      reperfusion. Of those receiving thrombolysis, median T AHA was 54 [37-72] 
      minutes, with 12.0%<30 minutes, while those receiving PCI, median T AHA was 58 
      [43-78] minutes, with 25.0%<90 minutes. In 2004-5, 52 patients had STEMI, with 40 
      (76.9%) receiving reperfusion. The percentage of patients meeting the guidelines 
      was 14.3% for the thrombolysis group and 11.1% for the PCI group. Introduction of 
      a dedicated EKG machine led to a strong trend towards improvement in median T2 
      (22 vs 10 minutes; P=0.07), but other treatment times remained unchanged. 
      CONCLUSIONS: Treatment times are longer than recommended guidelines. More 
      comprehensive strategies and improved coordination of medical services are 
      required to shorten pre-contact and post-contact response times.
FAU - Kaila, Kendeep S
AU  - Kaila KS
AD  - Department of Medicine, University of Manitoba, and Department of Emergency 
      Medicine, St. Boniface General Hospital, Manitoba.
FAU - Bhagirath, Kapil M
AU  - Bhagirath KM
FAU - Kass, Malek
AU  - Kass M
FAU - Avery, Lorraine
AU  - Avery L
FAU - Hall, Lillian
AU  - Hall L
FAU - Chochinov, Alex H
AU  - Chochinov AH
FAU - Tam, James W
AU  - Tam JW
LA  - eng
PT  - Journal Article
PL  - Canada
TA  - Mcgill J Med
JT  - McGill journal of medicine : MJM : an international forum for the advancement of 
      medical sciences by students
JID - 9710939
PMC - PMC2323485
OTO - NOTNLM
OT  - ACC/AHA guidelines
OT  - ST elevation myocardial infarction
OT  - reperfusion times
EDAT- 2008/06/05 09:00
MHDA- 2008/06/05 09:01
PMCR- 2007/07/01
CRDT- 2008/06/05 09:00
PHST- 2008/06/05 09:00 [pubmed]
PHST- 2008/06/05 09:01 [medline]
PHST- 2008/06/05 09:00 [entrez]
PHST- 2007/07/01 00:00 [pmc-release]
AID - mjm1002p075 [pii]
PST - ppublish
SO  - Mcgill J Med. 2007 Jul;10(2):75-80.