Catheterization Laboratory Activation Time in Patients Transferred With ST-Segment-Elevation Myocardial Infarction: Insights From the Mission: Lifeline STEMI Accelerator-2 Project.
Circ Cardiovasc Qual Outcomes
; 13(7): e006204, 2020 07.
Article
in En
| MEDLINE
| ID: mdl-32586105
ABSTRACT
BACKGROUND:
Catheterization laboratory (cath lab) activation time is a newly available process measure for patients with ST-segment-elevation myocardial infarction requiring inter-hospital transfers for primary percutaneous coronary intervention that reflects inter-facility communication and urgent mobilization of interventional laboratory resources. Our aim was to determine whether faster activation is associated with improved reperfusion time and outcomes in the American Heart Association Mission Lifeline Accelerator-2 Project. METHODS ANDRESULTS:
From April 2015 to March 2017, treatment times of 2063 patients with ST-segment-elevation myocardial infarction requiring inter-hospital transfer for primary percutaneous coronary intervention from 12 regions around the United States were stratified by cath lab activation time (first hospital arrival to cath lab activation within [timely] or beyond 20 minutes [delayed]). Median cath lab activation time was 26 minutes, with a delayed activation observed in 1241 (60.2%) patients. Prior cardiovascular or cerebrovascular disease, arterial hypotension at admission, and black or Latino ethnicity were independent factors of delayed cath lab activation. Timely cath lab activation patients had shorter door-in door-out times (40 versus 68 minutes) and reperfusion times (98 versus 135 minutes) with 80.1% treated within the national goal of ≤120 minutes versus 39.0% in the delayed group.CONCLUSIONS:
Cath lab activation within 20 minutes across a geographically diverse group of hospitals was associated with performing primary percutaneous coronary intervention within the national goal of ≤120 minutes in >75% of patients. While several confounding factors were associated with delayed activation, this work suggests that this process measure has the potential to direct resources and practices to more timely treatment of patients requiring inter-hospital transfer for primary percutaneous coronary intervention.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Outcome and Process Assessment, Health Care
/
Cardiac Catheterization
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Patient Transfer
/
Emergency Medical Services
/
Time-to-Treatment
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Percutaneous Coronary Intervention
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ST Elevation Myocardial Infarction
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Aged
/
Female
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Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Circ Cardiovasc Qual Outcomes
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2020
Document type:
Article
Publication country:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
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US
/
USA