Akutintervention (Primär-PCI) im Rahmen des Essener Herzinfarktverbundes

Abstract

In a German city (Essen, 490,000 people), a new network system for patients with ST elevation myocardial infarction (STEMI) was established in 2004. This included a so-called integrated care model (IV model) by participation of insurance companies. In a cooperative structure between invasive and noninvasive hospitals, general practitioners and cardiologists as well as emergency systems it could be realized, that every patient with STEMI will be treated by primary percutaneous coronary intervention (PCI) as soon as possible according to the current guidelines. The patient characteristics (age, gender, comorbidity, medication) were comparable to other trials and registries. The primary success rate was high (96.4%). The acute in-hospital results demonstrated a low mortality (7.6%). The time periods of delay were comparable to other registries. The symptom-to-balloon time was 239 min, the medical contact-to-balloon time 95 min, the door-to-balloon time 60 min, and the puncture-to-balloon time 18 min (median values). The STEMI network system in Essen demonstrates the possibility of modern therapy in patients with myocardial infarction (primary PCI) in a cooperative modality between all participants in the health-care system.

Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: a descriptive quality control study

“…Accordingly, better coordination and direct patient transfer to the catheter laboratory could lead to a reduction in DTB times in the PCI centres. Finally, the documented median total ischemia time of 181 min achieved in our network is comparable to European data derived from Germany (239 min) [ 15 ], Hungary (223 min) [ 16 ] and Sweden (175 min) [ 14 ]. In the APPOSITION-III trial, total ischemia times of 165, 270 and 360 min were reported for the Netherlands, Germany and France, respectively [ 18 ].…”

Behandlung des akuten Herzinfarkts

“…Aus dem Herzinfarktverbund in Essen berichten R. Jacksch et al über die Ergebnisse der Akutintervention im Rahmen des ersten in Deutschland realisierten Herzinfarktverbundes im Rahmen eines integrierten Versorgungsmodells [16].…”