Evidence map›Paper›PMID 35702143›Full record

ArticleJournal of the American College of Emergency Physicians open2022

Association of pre-hospital time intervals and clinical outcomes in ST-elevation myocardial infarction patients.

Martha H Mackay, Adam Chruscicki, Jim Christenson, John A Cairns, Terry Lee, Ricky Turgeon, John M Tallon, Jennifer Helmer, Joel Singer, Graham C Wong and 1 more

Abstract read
In one paragraph

Article in Journal of the American College of Emergency Physicians open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Martha H MackaySchool of Nursing University of British Columbia Vancouver British Columbia Canada.ORCID https://orcid.org/0000-0002-0290-9715
Adam ChruscickiDivision of Internal Medicine Vancouver Coastal Health Diamond Health Care Centre Vancouver British Columbia Canada.
Jim ChristensonDepartment of Emergency Medicine University of British Columbia Diamond Health Care Centre Vancouver British Columbia Canada.
John A CairnsDivision of Cardiology University of British Columbia Diamond Health Care Centre Vancouver British Columbia Canada.
Terry LeeCentre for Health Evaluation and Outcome Sciences University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada.
Ricky TurgeonSt. Paul's Hospital Vancouver British Columbia Canada.
John M TallonDepartment of Emergency Medicine University of British Columbia Diamond Health Care Centre Vancouver British Columbia Canada.
Jennifer HelmerBritish Columbia Emergency Health Services Vancouver British Columbia Canada.
Joel SingerCentre for Health Evaluation and Outcome Sciences University of British Columbia, St. Paul's Hospital Vancouver British Columbia Canada.
Graham C WongDivision of Cardiology University of British Columbia Diamond Health Care Centre Vancouver British Columbia Canada.
Christopher B FordyceDivision of Cardiology University of British Columbia Diamond Health Care Centre Vancouver British Columbia Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Study Objectives: Timely coronary reperfusion is critical for favorable outcomes after ST-elevation myocardial infarction (STEMI). A substantial proportion of the total ischemic time is patient related, occurring before first medical contact (FMC). We aimed to expand the limited current understanding of the associations between prehospital intervals and clinical outcomes. Methods: We conducted a retrospective analysis of consecutive STEMI patients who underwent primary percutaneous coronary intervention (pPCI) (January 2009-March 2016) and assessed the associations between prehospital intervals and the incidence of new heart failure, cardiogenic shock, and hospital length of stay (LOS), adjusting for important clinical variables. Results: A total of 773 patients (77% men, median age 65 years) met eligibility criteria. The median pre-911 activation interval was 29 minutes (interquartile range: 11, 89); the median 911 call to FMC interval was 12 minutes (interquartile range: 9, 15). In multivariable analysis, there was a V-shaped relationship between the pre-911 activation interval and outcomes: a lower likelihood of new heart failure (odds ratio [OR] 0.51; 95% confidence interval [CI]: 0.30, 0.87), cardiogenic shock (OR 0.40; 95% CI: 0.21, 0.75) and prolonged LOS (OR 0.24; 95% CI: 0.14, 0.42) for midrange intervals (11-88 minutes) when compared to the early (< 11-minute) interval. There was no statistically significant relationship between total pre-FMC time and FMC to device activation time. Conclusions: Among ambulance-transported STEMI patients receiving pPCI, the shortest and longest pre-911 activation time intervals were associated with poorer outcomes. However, variation in post-FMC interval alone was not associated with outcomes, suggesting that interventions to reduce pre-FMC intervals must be prioritized.

Indexed as

attitudes and practiceemergency medical serviceshealth knowledgeST‐elevation myocardial infarction

Identifiers

PMID35702143
PMCPMC9174874

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.