PMID- 21450642
OWN - NLM
STAT- MEDLINE
DCOM- 20120228
LR  - 20111026
IS  - 1741-8275 (Electronic)
IS  - 1741-8267 (Linking)
VI  - 18
IP  - 3
DP  - 2011 Jun
TI  - Importance and limits of pre-hospital electrocardiogram in patients with ST 
      elevation myocardial infarction undergoing percutaneous coronary angioplasty.
PG  - 526-32
LID - 10.1177/1741826710389395 [doi]
AB  - BACKGROUND: The purpose of this study is to present data on the effects of 
      pre-hospital electrocardiogram (PH-ECG) on the outcome of ST elevation myocardial 
      infarction (STEMI) patients treated with percutaneous coronary angioplasty (PCI) 
      included in a registry undertaken in the Italian region of Lombardy. Pre-hospital 
      12-lead electrocardiogram is recommended by current guidelines in order to 
      achieve faster times to reperfusion in patients with STEMI. METHODS: The registry 
      includes 3901 STEMI patients who underwent primary PCI over an 18-month period. 
      RESULTS: Mean age was 63 +/- 12 years. Admission through the emergency medical 
      system (EMS) occurred in 1603 patients (40%): they were older, more frequently 
      had previous MI, TIMI flow = 0 at entry and were more frequently in Killip class 
      >1 than patients who were not admitted through the EMS. Among the patients 
      admitted through the EMS, PH-ECG was obtained in 475 patients (12%). These 
      patients had less frequently an anterior MI, but more frequently had absence of 
      TIMI flow at entry than patients whose ECG was not teletransmitted. Moreover, 
      they had a significantly shorter first medical contact-to-balloon time and a 
      trend toward a lower 30-day death rate (5.3% vs 7.9 %, p = 0.06). However, only 
      patients in Killip class 2-3 had a significantly lower mortality when the 
      diagnostic ECG was transmitted, whereas no difference was found in Killip class 1 
      or Killip class 4 patients. CONCLUSIONS: In this registry, PH-ECG significantly 
      decreased first medical contact-to-balloon time. Attempts to achieve faster 
      reperfusion times should be undertaken, as this may result in improved outcome, 
      particularly in patients with mild to moderate symptoms of heart failure.
FAU - Martinoni, Alessandro
AU  - Martinoni A
AD  - Ospedale Fornaroli, Magenta, Italy.
FAU - De Servi, Stefano
AU  - De Servi S
FAU - Boschetti, Enrico
AU  - Boschetti E
FAU - Zanini, Roberto
AU  - Zanini R
FAU - Palmerini, Tullio
AU  - Palmerini T
FAU - Politi, Alessandro
AU  - Politi A
FAU - Musumeci, Giuseppe
AU  - Musumeci G
FAU - Belli, Guido
AU  - Belli G
FAU - De Paolis, Marcella
AU  - De Paolis M
FAU - Ettori, Federica
AU  - Ettori F
FAU - Piccaluga, Emanuela
AU  - Piccaluga E
FAU - Sangiorgi, Diego
AU  - Sangiorgi D
FAU - Repetto, Alessandra
AU  - Repetto A
FAU - D'Urbano, Maurizio
AU  - D'Urbano M
FAU - Castiglioni, Battistina
AU  - Castiglioni B
FAU - Fabbiocchi, Franco
AU  - Fabbiocchi F
FAU - Onofri, Marco
AU  - Onofri M
FAU - De Cesare, Nicoletta
AU  - De Cesare N
FAU - Sangiorgi, Giuseppe
AU  - Sangiorgi G
FAU - Lettieri, Corrado
AU  - Lettieri C
FAU - Poletti, Fabrizio
AU  - Poletti F
FAU - Pirelli, Salvatore
AU  - Pirelli S
FAU - Klugmann, Silvio
AU  - Klugmann S
CN  - Lombardima Study Group
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110214
PL  - England
TA  - Eur J Cardiovasc Prev Rehabil
JT  - European journal of cardiovascular prevention and rehabilitation : official 
      journal of the European Society of Cardiology, Working Groups on Epidemiology & 
      Prevention and Cardiac Rehabilitation and Exercise Physiology
JID - 101192000
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - *Electrocardiography
MH  - Emergency Medical Services/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/*therapy
MH  - Prognosis
MH  - *Registries
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Time Factors
EDAT- 2011/04/01 06:00
MHDA- 2012/03/01 06:00
CRDT- 2011/04/01 06:00
PHST- 2011/04/01 06:00 [entrez]
PHST- 2011/04/01 06:00 [pubmed]
PHST- 2012/03/01 06:00 [medline]
AID - 1741826710389395 [pii]
AID - 10.1177/1741826710389395 [doi]
PST - ppublish
SO  - Eur J Cardiovasc Prev Rehabil. 2011 Jun;18(3):526-32. doi: 
      10.1177/1741826710389395. Epub 2011 Feb 14.