Clinical Outcomes in Pre-Hospital Activation and Direct Cardiac Catheterisation Laboratory Transfer of STEMI for Primary PCI

Savage, M.; Hay, Karen; Doan, Tan; Bosley, Emma; Walters, D.; Denman, R.; Ranasinghe, Isuru; Raffel, O.

doi:10.1016/j.hlc.2022.01.008

Cited by 6 publications

(11 citation statements)

References 25 publications

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“…In Queensland, the state‐wide ambulance service (QAS) implemented a standardized prehospital protocol for identification, prehospital activation, and direct transfer to the catheter laboratory for suspected STEMI 28 . Previous research has indicated implementation of a systems‐based approach to STEMI care incorporating standardized prehospital protocols reduces disparities in treatment between sex and is associated with improved mortality 22,29 . These standardized prehospital protocols may have contributed to the lack of disparity in prehospital system delays and mortality between sexes in our study.…”

Section: Discussionmentioning

confidence: 87%

“…28 Previous research has indicated implementation of a systems-based approach to STEMI care incorporating standardized prehospital protocols reduces disparities in treatment between sex and is associated with improved mortality. 22,29 These standardized prehospital protocols may have contributed to the lack of disparity in prehospital system delays and mortality between sexes in our study.…”

Section: Discussionmentioning

confidence: 89%

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Sex differences in time to primary percutaneous coronary intervention and outcomes in patients presenting with ST‐segment elevation myocardial infarction

Savage

Hay

Walters

et al. 2022

Cathet Cardio Intervent

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Objectives: We assessed sex differences in treatment and outcomes in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).Background: Historically, delays to timely reperfusion and poorer outcomes have been described in women who suffer STEMI. However, whether these sex discrepancies still exist with contemporary STEMI treatment remains to be evaluated.Methods: Consecutive STEMI patients treated with primary PCI patients over a 10-year period (January 1, 2010 to December 31, 2019) from a tertiary referral center were assessed. Comparisons were performed between patient's sex. Primary outcomes were 30-day and 1-year mortality. Secondary outcomes were STEMI performance measures.Results: Most patients (n = 950; 76%) were male. Females were on average older (66.8 vs. 61.4 years males; p < 0.001). Prehospital treatment delays did not differ between sexes (54 min [IQR: 44-65] females vs. 52 min [IQR: 43-62] males; p = 0.061). STEMI performance measures (door-to-balloon, first medical contact-toballoon [FMCTB]) differed significantly with longer median durations in females and fewer females achieving FMCTB < 90 min (28% females vs. 39% males; p < 0.001).Women also experienced greater rates of initial radial arterial access failure (11.3% vs. 3.1%; p < 0.001). However, there were no significant sex differences in crude or adjusted mortality between sexes at 30-days (3.6% male vs. 5.1% female; p = 0.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 89%

Sex differences in time to primary percutaneous coronary intervention and outcomes in patients presenting with ST‐segment elevation myocardial infarction

Savage

Hay

Walters

et al. 2022

Cathet Cardio Intervent

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“…Therefore, our results suggest that CKD may be a stronger determinant of worse outcomes in NSTEMI patients compared to SDT (< 24 h vs. ≥ 24 h). In patients presenting STEMI, the relative mortality was found to increase by 7.5% for every 30-min delay in reperfusion [ 38 ], and pre-hospital activation and direct cardiac catheterization laboratory transfer were related to lower 1-year mortality (adjusted odds ratio: 5.3; 95% CI: 2.2–12.4; p < 0.001) [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with previous reports [ 13 , 44 ], CKD was an independent predictor of all-cause and cardiovascular mortality in our study. Therefore, although STD could be considered an important predictor of long-term outcomes in patients with STEMI [ 38 , 39 ], the obtained results underline the important effects of CKD on the long-term clinical outcomes in patients with NSTEMI. Although the population size may have been insufficient in our study, the used registry based on 20 tertiary high-volume university hospitals may provide meaningful results.…”

Section: Discussionmentioning

confidence: 99%

Effect of delayed hospitalization on 3-year clinical outcomes according to renal function in patients with non-ST-segment elevation myocardial infarction

et al. 2024

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Background We evaluated the effect of delayed hospitalization (symptom-to-door time [STD] ≥ 24 h) on 3-year clinical outcomes according to renal function in patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing new-generation drug-eluting stent (DES) implantation. Methods A total of 4513 patients with NSTEMI were classified into chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m 2 , n = 1118) and non-CKD (eGFR ≥ 60 mL/min/1.73 m 2 , n = 3395) groups. They were further sub-classified into groups with (STD ≥ 24 h) and without (STD < 24 h) delayed hospitalization. The primary outcome was the occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as all-cause death, recurrent myocardial infarction, any repeat coronary revascularization, and stroke. The secondary outcome was stent thrombosis. Results After multivariable-adjusted and propensity score analyses, the primary and secondary clinical outcomes were similar in patients with or without delayed hospitalization in both CKD and non-CKD groups. However, in both the STD < 24 h and STD ≥ 24 h groups, MACCE (p < 0.001 and p < 0.006, respectively) and mortality rates were significantly higher in the CKD group than in the non-CKD group. However, stent thrombosis rates were similar between the CKD and non-CKD groups and between the STD < 24 h and STD ≥ 24 h groups. Conclusions Chronic kidney disease appears to be a much more important determinant of MACCE and mortality rates than STD in patients with NSTEMI.

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“…Short-term and long-term mortality rates for the two sexes remain unclear, as are the causes of discrepancies in practice,7 in-hospital and prehospital treatment delays, and contradictory data. [12][13][14] There is a clear learning curve, and data are missing addressing the safety of transradial technique for PPCI of patients with STEMI in our community, but the transradial strategy is gaining rapid acceptability among cardiologists in our area of the world. Because of the paucity of research in this area, there is a compelling need to investigate the mortality and complication rates associated with percutaneous coronary intervention (PPCI) using a transradial technique.…”

Section: Introductionmentioning

confidence: 99%

Using a Transradial Method, The Results of Primary Percutaneous Coronary Intervention at a Tertiary Care Cardiac Centre

Khan,

Haq,

Sahito

et al. 2023

PJMHS

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Objective: The purpose of this study is to investigate the in-hospital outcomes of primary percutaneous coronary intervention (PCI) performed using a transradial technique in a cardiac centre that provides tertiary care. Study Design: Descriptive/ observational study Place and Duration: Department of cardiology, Peshawar Institute of Cardiology, Hayatabad phase 5 Peshawar, KPK in the duration from April, 2022 to September, 2022. Methods: 104 patients were included in the trial; all had ST-segment elevation myocardial infarction and had presented within 12 hours of symptom onset without a history of thrombolytic treatment, coronary angioplasty, or cardiac surgery. Patients were monitored for forearm hematoma and mortality during their hospital stays after diagnostic angiography and primary percutaneous coronary intervention (PCI) of the artery supplying the infarct.SPSS 24.0 was used to analyze all data. Results: There were majority 75 (72.1%) males and 29 (27.9%) females among all cases. Included patients had mean age 48.44±13.67 years and had mean BMI 27.6±3.48 kg/m2. 48 (46.2%) patients were smokers and most common comorbidity was diabetes found in 63 (60.6%) cases followed by HTN, CAD, hyperlipidemia and obesity. Success rate of PCI by using transradial method was found in 101 (97.1%) cases. Mortality was only found in 2 cases and post-procedure forearm hematoma was found in 1 patients. Mortality and forearm hematoma was found because of old age among patients. Conclusion: In this study, we came to the conclusion that primary percutaneous coronary intervention (PCI) performed using a transradial technique is a viable alternative that has great success rates in terms of both mortality rates and morbidity, such as hematoma of the forearm. Keywords: Primary percutaneous coronary intervention, transradial approach, Forearm hematoma, mortality

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Clinical Outcomes in Pre-Hospital Activation and Direct Cardiac Catheterisation Laboratory Transfer of STEMI for Primary PCI

Cited by 6 publications

References 25 publications

Sex differences in time to primary percutaneous coronary intervention and outcomes in patients presenting with ST‐segment elevation myocardial infarction

Sex differences in time to primary percutaneous coronary intervention and outcomes in patients presenting with ST‐segment elevation myocardial infarction

Effect of delayed hospitalization on 3-year clinical outcomes according to renal function in patients with non-ST-segment elevation myocardial infarction

Using a Transradial Method, The Results of Primary Percutaneous Coronary Intervention at a Tertiary Care Cardiac Centre

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