PMID- 33030581
OWN - NLM
STAT- MEDLINE
DCOM- 20211105
LR  - 20220428
IS  - 2193-6226 (Electronic)
IS  - 2193-6218 (Print)
IS  - 2193-6218 (Linking)
VI  - 116
IP  - 8
DP  - 2021 Nov
TI  - Prehospital management of patients with suspected acute coronary syndrome : Real 
      world experience reflecting current guidelines.
PG  - 694-697
LID - 10.1007/s00063-020-00739-3 [doi]
AB  - BACKGROUND: In case of suspected acute coronary syndrome (ACS), international 
      guidelines recommend to obtain a 12-lead ECG as soon as possible after first 
      medical contact, to administrate platelet aggregation inhibitors and 
      antithrombins, and to transfer the patient as quickly as possible to an emergency 
      department. METHODS: A German emergency care service database was retrospectively 
      analysed from 2014 to 2016. Data were tested for normal distribution and the 
      Mann-Whitney test was used for statistical analysis. Results are presented as 
      medians (IQR). RESULTS: A total of 1424 patients with suspected ACS were included 
      in the present analysis. A 12-lead ECG was documented in 96% of patients 
      (n = 1369). The prehospital incidence of ST-segment elevation myocardial 
      infarction (STEMI) was 18% (n = 250). In 981 patients (69%), acetylsalicylic acid 
      (ASA), unfractionated heparin (UFH), or ASA and UFH was given. Time in 
      prehospital care differed significantly between non-STEMI (NSTEMI) ACS 
      (37 [IQR 30, 44] min) and STEMI patients (33 [IQR 26, 40] min, n = 1395, 
      p < 0.0001). Most of NSTEMI ACS and STEMI patients were brought to the emergency 
      care unit, while 30% of STEMI patients were directly handed over to a cardiac 
      catheterization laboratory. CONCLUSIONS: Prehospital ECG helps to identify 
      patients with STEMI, which occurs in 18% of suspected ACS. Patients without 
      ST-elevations suffered from longer prehospital care times. Thus, it is tempting 
      to speculate that ST-elevations in patients prompt prehospital medical teams to 
      act more efficiently while the absence of ST-elevations even in patients with 
      suspected ACS might cause unintended delays. Moreover, this analysis suggests the 
      need for further efforts to make the cardiac catheterization laboratory the 
      standard hand-over location for all STEMI patients.
CI  - (c) 2020. The Author(s).
FAU - Eckle, V-S
AU  - Eckle VS
AD  - Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, 
      Charite-Universitatsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Germany. 
      veit-simon.eckle@charite.de.
FAU - Lehmann, S
AU  - Lehmann S
AD  - Klinik fur Anasthesiologie und Intensivmedizin, Universitatsklinikum Tubingen, 
      Tubingen, Germany.
FAU - Drexler, B
AU  - Drexler B
AD  - Klinik fur Anasthesiologie und Intensivmedizin, Universitatsklinikum Tubingen, 
      Tubingen, Germany.
LA  - eng
PT  - Journal Article
TT  - Praklinisches Management von Patienten mit akuter Angina-pectoris-Symptomatik : 
      Eine retrospektive Datenauswertung im Hinblick auf aktuelle Leitlinien.
DEP - 20201008
PL  - Germany
TA  - Med Klin Intensivmed Notfmed
JT  - Medizinische Klinik, Intensivmedizin und Notfallmedizin
JID - 101575086
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - *Acute Coronary Syndrome/diagnosis/therapy
MH  - Electrocardiography
MH  - *Emergency Medical Services
MH  - Heparin
MH  - Humans
MH  - *Myocardial Infarction/diagnosis/therapy
MH  - Retrospective Studies
PMC - PMC8566385
OTO - NOTNLM
OT  - Cardiac catheterization laboratory
OT  - NSTEMI
OT  - Prehospital ECG
OT  - STEMI
OT  - Time of prehospital care
COIS- S. Lehmann, B. Drexler and V.-S. Eckle declare that they have no competing 
      interests.
EDAT- 2020/10/09 06:00
MHDA- 2021/11/06 06:00
PMCR- 2020/10/08
CRDT- 2020/10/08 12:22
PHST- 2020/05/29 00:00 [received]
PHST- 2020/09/02 00:00 [accepted]
PHST- 2020/08/05 00:00 [revised]
PHST- 2020/10/09 06:00 [pubmed]
PHST- 2021/11/06 06:00 [medline]
PHST- 2020/10/08 12:22 [entrez]
PHST- 2020/10/08 00:00 [pmc-release]
AID - 10.1007/s00063-020-00739-3 [pii]
AID - 739 [pii]
AID - 10.1007/s00063-020-00739-3 [doi]
PST - ppublish
SO  - Med Klin Intensivmed Notfmed. 2021 Nov;116(8):694-697. doi: 
      10.1007/s00063-020-00739-3. Epub 2020 Oct 8.