Evidence map›Paper›PMID 36203049›Full record

ArticleCardiology and therapy2022

The Barriers to Rapid Reperfusion in Acute ST-Elevation Myocardial Infarction.

Kristian Bartnes, Hilde Albrigtsen, Johanne M Iversen, Henrik Brovold, Niels H Møller, Bjørn Wembstad, Frode Arstad, Andreas H Kristensen, Julia Cortis, Siv J Olsen and 5 more

2 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiology and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
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.

NCT04614805 completednot on this map

Mobilizing Clinical Leadership to Achieve Timely Reperfusion in Acute ST-segment Elevation Myocardial Infarction

Typeobservational_patient_registrySponsorUniversity Hospital of North NorwayRan2020 to 2023Enrolled146ConditionsAcute Myocardial InfarctionArmsMobilizing clinical leaders
NCT07092904 not yet recruitingnot on this mapstarted 2025, after this paper: background citation

iTide 2 - STEMI Follow-up Study

TypeobservationalSponsorUniversity Hospital of North NorwayRan2025 to 2026Enrolled200ConditionsInfarction
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. 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

15 authors at 3 institutions in 1 country.

Kristian BartnesDivision of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, P.O. Box 100, 9038, Tromsø, Norway. kristian.bartnes@unn.no.ORCID http://orcid.org/0000-0003-3203-1840
Hilde AlbrigtsenDepartment of Cardiology, University Hospital of North Norway, P.O. Box 100, 9038, Tromsø, Norway.
Johanne M IversenDepartment of Medicine, Nordlandssykehuset Bodø, 8092, Bodø, Norway.
Henrik BrovoldDepartment of Medicine Narvik, University Hospital of North Norway, P.O. Box 273, 8504, Narvik, Norway.
Niels H MøllerClinic of Medicine, Helgelandssykehuset, P.O. Box 601, 8607, Mo i Rana, Norway.
Bjørn WembstadDepartment of Medicine, Clinic of Hammerfest, Finnmarkssykehuset, Sykehusveien 35, 9601, Hammerfest, Norway.
Frode ArstadClinic of Medicine, Helgelandssykehuset, P.O. Box 613, 8801, Sandnessjøen, Norway.
Andreas H KristensenDepartment of Cardiology, University Hospital of North Norway, P.O. Box 100, 9038, Tromsø, Norway.
Julia CortisDepartment of Medicine, Nordlandssykehuset Vesterålen, Ivar Bergmos gt. 3, 8450, Stokmarknes, Norway.
Siv J OlsenDivision of Internal Medicine Harstad, University Hospital of North Norway, P.O. Box 1065, 9480, Harstad, Norway.
Ståle N S NygaardDepartment of Medicine, Clinic of Kirkenes, Finnmarkssykehuset, P.O. Box 410, 9915, Kirkenes, Norway.
Sven G KindlerDepartment of Medicine, Nordlandssykehuset Lofoten, Sykehusbakken 23, 8372, Gravdal, Norway.
Oddgeir MoeDivision of Cardiothoracic and Respiratory Medicine, University Hospital of North Norway, P.O. Box 100, 9038, Tromsø, Norway.
Christian HansenClinic of Medicine, Helgelandssykehuset, P.O. Box 568, 8801, Mosjøen, Norway.
Jan T MannsverkDepartment of Cardiology, University Hospital of North Norway, P.O. Box 100, 9038, Tromsø, Norway.
University Hospital of North Norway · NONordland Hospital Trust · NOFinnmarkssykehuset · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aimed to quantify the contribution of various obstacles to timely reperfusion therapy in acute ST-elevation myocardial infarction (STEMI) and to improve performance in a mixed remote rural/urban region.

methodsFrom November 1, 2020 to April 23, 2021, patients with acute STEMI were prospectively monitored with the critical time intervals, treatment modalities, and outcomes registered. Selected clinical decision-makers in 11 hospitals were appointed as improvement agents and systematically provided with weekly updated information about absolute and relative performance. Suggestions for improvements were invited and shared.

resultsOnly 29% of the 146 patients received reperfusion therapy within recommended time limits [prehospital thrombolysis, 2/48; in-hospital thrombolysis, 0/20; primary percutaneous coronary intervention (pPCI), 37/68, with median intervals from the first medical contact of 44, 49, and 133 min, respectively]. Efficiency varied considerably between health trusts: median time from the first medical contact to prehospital thrombolysis ranged from 29 to 54 min (hazard ratio 4.89). The predominant, remediable causes for delays were erroneous tactical choices and protracted electrocardiographic diagnostication, decision-making, and administration of fibrinolytic medication. During the trial, the time to pPCI was non-significantly reduced.

conclusionWe found several targets for system improvements in order to mitigate reperfusion delays along the entire chain of care, regardless of reperfusion modality chosen. More patients should receive prehospital thrombolysis. The most important measures will be training to ensure a more efficient on-site workflow, improved protocols and infrastructure facilitating the communication between first responders and in-hospital clinicians, and education emphasizing prehospital transport times. CLINICAL TRIALS IDENTIFIER: NCT04614805.

Indexed as

Acute ST-elevation myocardial infarctionPrimary percutaneous coronary interventionThrombolysis

Identifiers

PMID36203049
PMCPMC9652182
OpenAlexW4302424583

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.