PMID- 24388497
OWN - NLM
STAT- MEDLINE
DCOM- 20141230
LR  - 20140512
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 23
IP  - 5
DP  - 2014 May
TI  - Pre-hospital ambulance notification and initiation of treatment of ST elevation 
      myocardial infarction is associated with significant reduction in door-to-balloon 
      time for primary PCI.
PG  - 435-43
LID - S1443-9506(13)01363-2 [pii]
LID - 10.1016/j.hlc.2013.11.015 [doi]
AB  - BACKGROUND: Mortality in ST elevation myocardial infarction (STEMI) is strongly 
      predicted by the time from first medical contact to reperfusion. The aim of this 
      study was to examine the impact of pre-hospital diagnosis by paramedics in the 
      field on the door-to-balloon (DTB) times of patients with ST elevation myocardial 
      infarction undergoing primary percutaneous intervention. METHODS: Paramedics in 
      the field identified patients with ST elevation myocardial infarction on a 
      12-lead electrocardiograph, activated the cardiac catheter laboratory team from 
      the field and initiated therapy with anticoagulants and antiplatelet agents in 
      the pre-hospital setting. This cohort of patients was compared to a similar group 
      of patients without pre-hospital diagnosis and notification. The primary outcome 
      measure was DTB times. A secondary end point was mortality at 30 days and 
      mortality at six months. RESULTS: A total of 281 patients, mean age of 61.1+/-12.9 
      years underwent primary percutaneous intervention with pre-hospital notification 
      occurring in 63 cases. DTB times were lower in those with pre notification than 
      in those without pre-hospital notification (40.4 vs. 75.6 minutes, p<0.001). This 
      represented a 47.6% shorter DTB time. A non-statistically significant mortality 
      reduction at one month and six months was observed in the pre-hospital 
      notification group (1.6 versus 4.3%, p= 0.307 and 1.6 versus 6.4%, p= 0.203, 
      respectively). CONCLUSION: Pre-hospital intervention at our centre had a powerful 
      effect in reducing the time to reperfusion in patients with STEMI undergoing 
      primary percutaneous intervention.
CI  - Copyright (c) 2013 Australian and New Zealand Society of Cardiac and Thoracic 
      Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). 
      All rights reserved.
FAU - Savage, Michael L
AU  - Savage ML
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia.
FAU - Poon, Karl K C
AU  - Poon KK
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, 
      Australia.
FAU - Johnston, Erin M
AU  - Johnston EM
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia.
FAU - Raffel, Owen Christopher
AU  - Raffel OC
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, 
      Australia.
FAU - Incani, Alexander
AU  - Incani A
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, 
      Australia.
FAU - Bryant, John
AU  - Bryant J
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia.
FAU - Rashford, Stephen
AU  - Rashford S
AD  - Queensland Ambulance Service, GPO Box 1425, Brisbane 4001, Queensland, Australia.
FAU - Pincus, Matthew
AU  - Pincus M
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, 
      Australia.
FAU - Walters, Darren L
AU  - Walters DL
AD  - Cardiology Program, The Prince Charles Hospital, Chermside, Brisbane 4032, 
      Queensland, Australia; University of Queensland, St Lucia, Brisbane, Queensland, 
      Australia. Electronic address: Darren_walters@health.qld.gov.au.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20131211
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Aged
MH  - Ambulances
MH  - *Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnosis/mortality/physiopathology/*surgery
MH  - *Percutaneous Coronary Intervention
MH  - *Preoperative Period
MH  - Time Factors
OTO - NOTNLM
OT  - Angioplasty
OT  - ECG.
OT  - Myocardial infarction
OT  - ST elevation
EDAT- 2014/01/07 06:00
MHDA- 2014/12/31 06:00
CRDT- 2014/01/07 06:00
PHST- 2012/11/05 00:00 [received]
PHST- 2013/11/10 00:00 [revised]
PHST- 2013/11/28 00:00 [accepted]
PHST- 2014/01/07 06:00 [entrez]
PHST- 2014/01/07 06:00 [pubmed]
PHST- 2014/12/31 06:00 [medline]
AID - S1443-9506(13)01363-2 [pii]
AID - 10.1016/j.hlc.2013.11.015 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2014 May;23(5):435-43. doi: 10.1016/j.hlc.2013.11.015. Epub 2013 
      Dec 11.