[Impact of new regional cooperative rescue model on first medical contact to balloon time and outcome in patients with ST-segment elevation myocardial infarction].

ABSTRACT

OBJECTIVE: To evaluate the effect of new regional cooperative rescue model on the first medical contact-to-balloon time and outcome in patients with ST-elevation myocardial infarction. METHOD: Patients with acute myocardial infraction (AMI) and onset time within 24 hours transferred from other hospitals to our clinic and underwent emergent percutaneous coronary intervention (PCI) between January 2010 and January 2013 were included in this study. Patients were divided into two groups regional cooperative treatment group (n = 230) and control group (n = 168) according to whether the first contact clinic belongs to the regional cooperative rescue model or not. The first medical contact to balloon (FMC-to-B) time, door to balloon (D-to-B) time, referral time, cardiac function, mean cost, days of hospitalization, and major adverse cardiac event (MACE) during the 6 months follow up were compared. RESULTS: Mean FMC-to-B time, D-to-B time and referral time were significantly decreased from (212 ± 37), (107 ± 18), (103 ± 23) min (control group) to (98 ± 23), (25 ± 7), (62 ± 12) min respectively in regional cooperative treatment group. Mean medical cost (42 221 (23 184, 77 768) RMB vs. 49 654 (25 126, 122 433) RMB) and days of hospitalization (7 (5, 13) days vs. 10 (6, 20) days) were also significantly lower in regional cooperative treatment group than in control group. At 6 months follow up, LVEF was significantly higher(54.9% ± 8.6% vs. 48.9% ± 9.1%, P = 0.01), LVEDD ((48.9 ± 5.7)mm vs.(51.4 ± 6.0) mm, P < 0.01) as well as MACE rate (7.4% (17/230) vs. 17.9% (30/168) , P < 0.05) were significantly lower in regional cooperative treatment group than in control group. CONCLUSION: The regional cooperative rescue model can decrease the FMC-to-B time, improve cardiac function, and reduce both patients' financial burden and MACE in patients with acute myocardial infarction.