PMID- 34406317 OWN - NLM STAT- MEDLINE DCOM- 20211214 LR - 20220607 IS - 1678-4170 (Electronic) IS - 0066-782X (Print) IS - 0066-782X (Linking) VI - 117 IP - 6 DP - 2021 Dec TI - Training Non-Cardiologists Could Improve the Treatment Results of ST Elevation Myocardial Infarction. PG - 1073-1078 LID - 10.36660/abc.20200180 [doi] AB - BACKGROUND: According to the World Health Organization, emerging countries will have an enormous growth in the number of heart attacks and related deaths. The main medical issue in Brazil is mortality caused by acute ST elevation myocardial infarction (STEMI). The Society of Cardiology in the State of Sao Paulo has never trained non-cardiologists as emergency personnel. Patients usually seek help from emergency departments instead of calling for an ambulance. OBJECTIVES: We aimed at reducing in-hospital death rates from acute myocardial infarction by training emergency personnel in the city of Sao Paulo. METHODS: We used a training program for the personnel of five hospitals with >100 patients admitted with STEMI per year, and at least 15% in-hospital STEMI-associated mortality rate. We performed internet training, biannual-quarterly symposia for up to 400 participants, informative folders and handouts. Statistical analysis used the two proportion comparison test with p <0.05. RESULTS: Nearly 200 physicians and 350 nurses attended at least one training from May 2010 to December 2013. Initially, many emergency physicians could not recognize an acute myocardial infarction on the electrocardiogram, but tele-electrocardiography is used in some emergency departments to determine the diagnosis. The death rate in the five hospitals decreased from 25.6%, in 2009, to 18.2%, in 2010 (p=0.005). After the entire period of training, the STEMI-associated death rate in all public hospitals of Sao Paulo decreased from 14.31%, in 2009, to 11.25%, in 2014 (p<0.0001). CONCLUSION: Even simple training programs for emergency personnel can greatly reduce acute myocardial infarction death rates in undeveloped countries. FAU - Cesar, Luiz Antonio Machado AU - Cesar LAM AUID- ORCID: 0000-0003-4436-1791 AD - InCor - Instituto do Coracao do Hospital das Clinicas da FMUSP, Sao Paulo, SP - Brasil. FAU - Mansur, Antonio Padua AU - Mansur AP AUID- ORCID: 0000-0003-3051-1090 AD - InCor - Instituto do Coracao do Hospital das Clinicas da FMUSP, Sao Paulo, SP - Brasil. FAU - Ramos, Rui Fernando AU - Ramos RF AD - Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP - Brasil. FAU - Magalhaes, Carlos AU - Magalhaes C AD - Universidade Nove de Julho, Sao Paulo, SP - Brasil. FAU - Ferreira, Joao Fernando Monteiro AU - Ferreira JFM AD - InCor - Instituto do Coracao do Hospital das Clinicas da FMUSP, Sao Paulo, SP - Brasil. FAU - Mioto, Bruno Mahler AU - Mioto BM AD - InCor - Instituto do Coracao do Hospital das Clinicas da FMUSP, Sao Paulo, SP - Brasil. FAU - Oliveira, Naide Aparecida de AU - Oliveira NA AD - Secretaria da Saude do Estado de Sao Paulo, Sao Paulo, SP - Brasil. FAU - Farsky, Pedro Silvio AU - Farsky PS AD - Secretaria da Saude do Estado de Sao Paulo, Sao Paulo, SP - Brasil. FAU - Amaral, Amaury Zatorre AU - Amaral AZ AD - Secretaria Municipal da Saude, Sao Paulo, SP - Brasil. FAU - Moreno, Antonio Celio Camargo AU - Moreno ACC AD - Secretaria de Gestao Publica, Sao Paulo, SP - Brasil. LA - eng LA - por PT - Journal Article TT - Treinamento de Nao-Cardiologistas pode Melhorar os Resultados do Tratamento de Infarto Agudo do Miocardio com Supra de ST. PL - Brazil TA - Arq Bras Cardiol JT - Arquivos brasileiros de cardiologia JID - 0421031 SB - IM EIN - Arq Bras Cardiol. 2021 Nov;117(5):1060. PMID: 34817019 CIN - Arq Bras Cardiol. 2021 Dec;117(6):1079-1080. PMID: 35613164 MH - Brazil/epidemiology MH - Electrocardiography MH - *Emergency Medical Services MH - Hospital Mortality MH - Humans MH - *Myocardial Infarction/therapy MH - *ST Elevation Myocardial Infarction/diagnosis/therapy PMC - PMC8757147 OAB - BACKGROUND: According to the World Health Organization, emerging countries will have an enormous growth in the number of heart attacks and related deaths. The main medical issue in Brazil is mortality caused by acute ST elevation myocardial infarction (STEMI). The Society of Cardiology in the State of Sao Paulo has never trained non-cardiologists as emergency personnel. Patients usually seek help from emergency departments instead of calling for an ambulance. OBJECTIVES: We aimed at reducing in-hospital death rates from acute myocardial infarction by training emergency personnel in the city of Sao Paulo. METHODS: We used a training program for the personnel of five hospitals with >100 patients admitted with STEMI per year, and at least 15% in-hospital STEMI-associated mortality rate. We performed internet training, biannual-quarterly symposia for up to 400 participants, informative folders and handouts. Statistical analysis used the two proportion comparison test with p <0.05. RESULTS: Nearly 200 physicians and 350 nurses attended at least one training from May 2010 to December 2013. Initially, many emergency physicians could not recognize an acute myocardial infarction on the electrocardiogram, but tele-electrocardiography is used in some emergency departments to determine the diagnosis. The death rate in the five hospitals decreased from 25.6%, in 2009, to 18.2%, in 2010 (p=0.005). After the entire period of training, the STEMI-associated death rate in all public hospitals of Sao Paulo decreased from 14.31%, in 2009, to 11.25%, in 2014 (p<0.0001). CONCLUSION: Even simple training programs for emergency personnel can greatly reduce acute myocardial infarction death rates in undeveloped countries. OABL- eng COIS- Potencial conflito de interesse Nao ha conflito com o presente artigo EDAT- 2021/08/19 06:00 MHDA- 2021/12/15 06:00 PMCR- 2021/08/02 CRDT- 2021/08/18 12:24 PHST- 2020/01/07 00:00 [received] PHST- 2021/01/27 00:00 [accepted] PHST- 2021/08/19 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/08/18 12:24 [entrez] PHST- 2021/08/02 00:00 [pmc-release] AID - S0066-782X2021005013201 [pii] AID - abc.20200180 [pii] AID - 10.36660/abc.20200180 [doi] PST - ppublish SO - Arq Bras Cardiol. 2021 Dec;117(6):1073-1078. doi: 10.36660/abc.20200180.