Time layout for primary percutaneous coronary intervention in patients with acute ST elevated myocardial infarction / 解放军医学杂志

ABSTRACT

Objective To analyze the treatment time layout in different phases and related factors in patients with acute ST elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods The study was a cross-sectional and single center registry. Data of 211 patients with STEMI admitted within 12 hours of onset to the Emergency Department of the 306 Hospital of PLA between January 1, 2013 and July 31, 2014 were collected. The following median times were recorded and compared with that in 2013 ACC/AHA guideline: symptom onset-summoning the ambulance servicesambulance arrival-ambulance arriving at emergency department (ED)-consent to primary PCI-arriving at catheterization laboratoryfirst balloon dilatation. Results Of the 211 patients with STEMI, 150 (71%) were transported to the 306 Hospital of PLA by ambulance, and the remaining 61 (29%) arrived at hospital by themselves. Through it all 3 time slots delayed: the median time of door to balloon (DTB) was 105min, did not reach the standard according to 2013 ACC/AHA guideline (<90min); from symptom onset to summoning an ambulance was 62min, and from arriving at the hospital to consent to primary PCI was 50min. Conclusions The patient's own delay is the main cause of pre-hospital delay, the time of obtaining an informed consent plays an important role in treatment delay. Many patients are not aware of the importance for early reperfusion therapy.