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The Effect of Prehospital Telecardiology on the Mortality and Morbidity of St-Segment Elevated Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention: A Cross-Sectional Study Publisher



Saberian P1, 2 ; Tavakoli N3 ; Hasanisharamin P4 ; Sezavar SH5 ; Dadashi F4 ; Vahidi E1, 6
Authors
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Authors Affiliations
  1. 1. Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Tehran Emergency Medical Service Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  5. 5. Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Emergency Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Turkish Journal of Emergency Medicine Published:2020


Abstract

OBJECTIVES: The sooner the primary percutaneous coronary intervention (PPCI) is performed, the better prognosis is expected in patients with acute myocardial infarction. The objective is to evaluate the effect of prehospital triage based on electrocardiogram (ECG) and telecardiology on the mortality and morbidity of ST-segment elevated myocardial infarction (STEMI) patients undergoing PPCI. METHODS: This cross-sectional study was conducted based on the data extracted from the hospital information system (HIS) of one general hospital, which had the capability of performing PPCI 24 h a day, 7 days a week. All patients with STEMI who undergone PPCI during 1 year, transferred by emergency medical service (EMS) and their data were registered in the HIS were eligible. Besides the baseline characteristics, first medical contact (FMC)‑to‑balloon time was recorded. Morbidity based on predischarge left ventricular ejection fraction (LVEF) and mortality based on Global Registry of Acute Cardiac Events (GRACE) score were also recorded. Patients who were referred to the hospital by EMS with prehospital ECG and telecardiology were compared with those without prehospital ECG. RESULTS: Totally, 298 patients with STEMI were enrolled, of whom 183 patients (61.4%) had prehospital ECG (telecardiology), and 115 patients (38.6%) had not. The means of predischarge LVEF of the patients in the first and the second groups were 40.7 ± 10.4 and 40.6 ± 11.2, respectively (P = 0.946). The mean of the probability of 6-month mortality based on GRACE score in the first group was significantly less than that of the second group (P = 0.004). Analyses of multivariable ordinal logistic regression showed that 6-month mortality severity risk in the second group was 1.5 times more than the first group (95% confidence interval 0.8–2.6), although this difference was not statistically significant (P = 0.199). © 2020 Turkish Journal of Emergency Medicine
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2. Effects of Prehospital Traige and Diagnosis of St Segment Elevation Myocardial Infarction on Mortality Rate, International Journal of General Medicine (2020)
3. One-Month Clinical Outcomes of St-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention at a High-Volume Cardiac Tertiary Center: Routine Hours Versus Off-Hours, Critical Pathways in Cardiology (2020)
4. Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With St-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (Pci) According to the 24/7 Primary Pci Service Registry in Iran: Protocol for a Cross-Sectional Study, JMIR Research Protocols (2019)
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