ArticleMcGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students2007
Reperfusion times for ST elevation myocardial infarction: a prospective audit.
Article in McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- Brazilian Guideline for the Evaluation and Diagnosis of Chest Pain in the Emergency Department - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Improving use of proton pump inhibitors with dual antiplatelet therapy in patients admitted with acute coronary syndrome.BMJ open quality · 2022Article
- A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction.Scientific reports · 2021Article
- Improving door-to-needle times for patients presenting with ST-elevation myocardial infarction at a rural district general hospital.BMJ quality improvement reports · 2016Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNew published guidelines recommend treatment of ST elevation myocardial infarction (STEMI) within 30 minutes of first medical contact to thrombolysis and 90 minutes to primary percutaneous coronary intervention (PCI).
objectivesTo determine how a tertiary care center compares to these new guidelines and to evaluate the success of measures directed to shorten delays.
methodsThis was a prospectively designed audit loop using retrospective chart review. Specific time intervals were evaluated: 1) T2 (ER presentation to diagnostic EKG; 2) T ER (ER presentation to reperfusion); and 3) T AHA (first medical contact to reperfusion). Results of the initial 12-month data were conveyed to Emergency Room staff and a dedicated EKG machine was placed in the ER for the subsequent 12 months, and the results were then re-analyzed.
resultsIn 2003-4, 58 patients with STEMI were identified, with 41 (70.7%) receiving reperfusion. Of those receiving thrombolysis, median T AHA was 54 [37-72] minutes, with 12.0%<30 minutes, while those receiving PCI, median T AHA was 58 [43-78] minutes, with 25.0%<90 minutes. In 2004-5, 52 patients had STEMI, with 40 (76.9%) receiving reperfusion. The percentage of patients meeting the guidelines was 14.3% for the thrombolysis group and 11.1% for the PCI group. Introduction of a dedicated EKG machine led to a strong trend towards improvement in median T2 (22 vs 10 minutes; P=0.07), but other treatment times remained unchanged.
conclusionsTreatment times are longer than recommended guidelines. More comprehensive strategies and improved coordination of medical services are required to shorten pre-contact and post-contact response times.
Indexed as
Identifiers
18523608PMC2323485What OpenQuestion holds
Registered trials
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