Analysis of times from symptoms onset to percutaneous coronary intervention

Giuliani E, Melegari G, Lazzerotti S, Fantini G, Serantoni C, Barbieri A

Introduction: ST-elevation myocardial infarction (STEMI) must be treated early and

aggressively. The aim of this retropective observational study was to measure the times

from first medical contact (FMC) to balloon inflation and from symptoms onset to

balloon inflation.

Methods: The consecutive records of all the patients who underwent a primary

percutaneous coronary intervention (PCI) for STEMI at in the catheterization laboratory over a 12-month period were included. Patients were classified as: group A if emergency medical

responders brought them directly to the catheterization laboratory or to the emergency

department, group B if they were self-presenters to the emergency department. The duration of the process was calculated in 2 ways, from symptoms onset (T1) to balloon inflation and from FMC (T2) to balloon inflation. Relevant medical history and hospital and 30-day mortality were extracted from medical records.

Results: Seventy-five patients (group A, 42; group B, 33). The groups were similar in sex,

age, and hospital and 30-day mortality. Times until balloon inflation from T1 and T2 in

group A were 149.5 and 98 minutes, in group B the times were 147 and 90 minutes,

respectively (P=.9498 between groups for the times from T1; P=.0404 between groups for

the times from T2). The differences between T1 and T2 (P<.0001 and P<.0001, respectively). The delay between T1 and FMC showed a statistically significant correlation with hospital mortality (rise in mortality of 5.94% for every 10-minute delay, P=.0110). Conclusions: The time between symptoms onset and FMC in STEMI management Primary care doctors would be the most appropriate professionals to educate the population at risk about the need to call emergency medical services or go to a hospital emergency department quickly.

Barbieri A, Fantini G, Giuliani E, Lazzerotti S, Melegari G, Serantoni C