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Transfer distance effect on reperfusion: timeline of ST-elevation patients transferred for primary percutaneous coronary intervention.

MedStar author(s):

Barbash, Israel M

Loh, Joshua P

Magalhaes, Marco A

Minha, Sa'ar

Pendyala, Lakshmana K

Citation: Cardiovascular Revascularization Medicine. 15(8):369-74, 2014 Nov-Dec.PMID: 25223909Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleSubject headings: *Angioplasty, Balloon, Coronary/mo [Mortality] | *Myocardial Infarction/mo [Mortality] | *Percutaneous Coronary Intervention/mo [Mortality] | Adult | Aged | Aged, 80 and over | District of Columbia | Emergency Treatment/mo [Mortality] | Hospital Mortality | Humans | Hydroxymethylglutaryl-CoA Reductase Inhibitors/bl [Blood] | Middle Aged | Patient Transfer | Time Factors | Treatment OutcomeLocal holdings: Available in print through MWHC library: 2002 - presentISSN:

1878-0938

Abstract: BACKGROUND: Regional emergency care systems were designed to decrease delays in reperfusion of patients but the effect of transfer distance on outcome is less established.CONCLUSIONS: For STEMI patients presenting to a non-PCI capable center, a network care system for PCI mitigates the distance factor on DTB time. This is turn translates into comparable outcomes.Copyright � 2014 Elsevier Inc. All rights reserved.METHODS: We compare the characteristics and outcomes of STEMI patients transferred from a distance >25 miles (GT25) to those transferred from distances <25 miles (LT25) by utilizing data from a regional STEMI care network in the greater Washington DC area.OBJECTIVES: This study aims to establish if transfer distance impacts the outcome of ST-elevation myocardial infarction (STEMI) patients transferred to a percutaneous coronary intervention (PCI).RESULTS: Within the transferred patients (n=1065), 609 patients (57%) were transferred from GT25 (median distance 36 miles), while 456 (43%) were transferred from LT25 (median distance 13 miles). Most of the baseline characteristics between the groups were similar. Door-to-balloon (DTB) was defined as the time elapsed from the presentation to the center without PCI capability to flow restoration in the culprit artery. No differences were noted in the median DTB (GT25: 158min [122-213] vs. 149 [118-219]; p=0.5) or in in-hospital mortality (8% vs. 7.2%; p=0.617). By implementing the regional STEMI care network, a constant decrease in DTB was noted throughout its years of operation.All authors: Barbash IM, Loh JP, Magalhaes MA, Minha S, Pendyala LK, Pichard AD, Satler LF, Suddath WO, Torguson R, Waksman RDigital Object Identifier:

http://dx.doi.org/10.1016/j.carrev.2014.08.003

Date added to catalog: 2016-01-13

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article		Available		25223909

Available in print through MWHC library: 2002 - present

BACKGROUND: Regional emergency care systems were designed to decrease delays in reperfusion of patients but the effect of transfer distance on outcome is less established.

CONCLUSIONS: For STEMI patients presenting to a non-PCI capable center, a network care system for PCI mitigates the distance factor on DTB time. This is turn translates into comparable outcomes.Copyright � 2014 Elsevier Inc. All rights reserved.

METHODS: We compare the characteristics and outcomes of STEMI patients transferred from a distance >25 miles (GT25) to those transferred from distances <25 miles (LT25) by utilizing data from a regional STEMI care network in the greater Washington DC area.

OBJECTIVES: This study aims to establish if transfer distance impacts the outcome of ST-elevation myocardial infarction (STEMI) patients transferred to a percutaneous coronary intervention (PCI).

RESULTS: Within the transferred patients (n=1065), 609 patients (57%) were transferred from GT25 (median distance 36 miles), while 456 (43%) were transferred from LT25 (median distance 13 miles). Most of the baseline characteristics between the groups were similar. Door-to-balloon (DTB) was defined as the time elapsed from the presentation to the center without PCI capability to flow restoration in the culprit artery. No differences were noted in the median DTB (GT25: 158min [122-213] vs. 149 [118-219]; p=0.5) or in in-hospital mortality (8% vs. 7.2%; p=0.617). By implementing the regional STEMI care network, a constant decrease in DTB was noted throughout its years of operation.

English