ArticlePrehospital emergency care2024
Rural EMS STEMI Patients - Why the Delay to PCI?
Article in Prehospital emergency care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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.
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.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Sex differences in rural prehospital ST-segment elevation myocardial infarction care.Emergency medicine journal : EMJ · 2026Article
- Pre-Hospital Delay in STEMI: A Narrative Review of Symptom Onset-to-First Medical Contact Across High-Income and Low- and Middle-Income Countries.Clinical cardiology · 2026Review
- Relationship of Distance to PCI Center With In-Hospital Mortality After STEMI: Insights From a Rural Regional STEMI Network.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Nationwide trends and disparities in deaths following cardiogenic shock and sepsis in the United States (1999-2023): insights from the CDC WONDER database.BMC cardiovascular disorders · 2025Article
- Bridging the gaps in interventional cardiology disparities-socioeconomic, geographic, and political inequalities.European heart journal open · 2025Review
- Mixed-Methods Investigation of Rural Emergency Medical Services ST-Elevation Myocardial Infarction Time to Percutaneous Coronary Intervention: High- vs Low-Performing Agencies.The western journal of emergency medicine · 2025Article
- Feasibility of implementing reperfusion strategies in STEMI codes in a mountainous population remote from a PCI-capable center.REC, interventional cardiologyArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe objective of this study is to identify patient and EMS agency factors associated with timely reperfusion of patients with ST-elevation myocardial infarction (STEMI).
methodsWe conducted a cohort study of adult patients (≥18 years old) with STEMI activations from 2016 to 2020. Data was obtained from a regional STEMI registry, which included eight rural county EMS agencies and three North Carolina percutaneous coronary intervention (PCI) centers. On each patient, prehospital and in-hospital time intervals were abstracted. The primary outcome was the ability to achieve the 90-minute EMS FMC to PCI time goal (yes vs. no). We used generalized estimating equations accounting for within-agency clustering to evaluate the association between patient and agency factors and meeting first medical contact (FMC) to PCI time goal while accounting for clustering within the agency.
resultsAmong 365 rural STEMI patients 30.1% were female (110/365) with a mean age of 62.5 ± 12.7 years. PCI was performed within the time goal in 60.5% (221/365) of encounters. The FMC to PCI time goal was met in 45.5% (50/110) of women vs 69.8% (178/255) of men (
conclusionNearly 40% of rural STEMI patients transported by EMS failed to receive FMC to PCI within 90 min. Women were less likely than men to receive reperfusion within the time goal, which represents an important health care disparity.
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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.