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Article
Impact of 24-hr in-hospital interventional cardiology team on timeliness of reperfusion for ST-segment elevation myocardial infarction
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
  • Suhail Allaqaband, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care
  • M. Fuad Jan, Aurora Cardiovascular Services, Aurora Health Care
  • Wamiq Y Banday, Aurora Health Care
  • Angela Schlemm, Aurora Health Care
  • S Hinan Ahmed
  • Naoyo Mori
  • Neil B Oldridge, Aurora Health Care
  • Anjan Gupta, Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health
  • Tanvir Bajwa, Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, University of Wisconsin School of Medicine and Public Health
Aurora Affiliations
Aurora Cardiovascular Services, Aurora Sinai/St. Luke’s Medical Centers
Publication Date
6-1-2010
Abstract

OBJECTIVE: We studied the effect of 24 hr a day, 7 days a week interventional cardiology staff on door-to-balloon (D2B) time and mortality in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI).

BACKGROUND: Any delay in PPCI in acute STEMI is associated with higher mortality and, therefore, time to treatment should be as short as possible. Despite the use of several strategies, goal D2B time ofelusive.

METHODS: The study examined 790 consecutive STEMI patients treated with PPCI as the reperfusion therapy of choice. Patients were grouped into a pre-24 x 7 and post-24 x 7 cohort to study the impact of the new protocol on D2B time and major adverse cardiovascular events (MACE) and mortality.

RESULTS: Median D2B time decreased from 99 min in the pre-24 x 7 group to 55 min in the post-24 x 7 group (P = 0.001) and was not influenced by time of day or day of week. Adjusted for patient and clinical characteristics, the pre-24 x 7 group had increased in-hospital cardiovascular mortality (odds ratio 1.94, 95% confidence interval 0.95-3.94; P = 0.048) and MACE (odds ratio 1.66, 95% confidence interval 1.10-2.49; P = 0.009) compared with the post-24 x 7 group. Prolonged D2B time was also associated with higher 1-year overall mortality in the pre-24 x 7 group compared with the post-24 x 7 group (12.8% vs. 8.1%; hazard ratio 1.17, 95% confidence interval 1.04-2.66; P = 0.044).

CONCLUSIONS: Round-the-clock, in-hospital interventional cardiology team consistently and significantly reduces D2B time, in-hospital cardiovascular mortality, MACE, and 1-year mortality in patients with STEMI.

Document Type
Article
PubMed ID
20517963
DOI
10.1002/ccd.22419
Citation Information
Allaqaband S, Jan MF, Banday WY, et al. Impact of 24-hr in-hospital interventional cardiology team on timeliness of reperfusion for ST-segment elevation myocardial infarction. Catheter Cardiovasc Interv. 2010 Jun 1;75(7):1015-23.