Predictive Ability and Efficacy for Shortening Door-to-balloon Time of a New Prehospital Electrocardiogram-transmission Flow Chart in Patients with ST-elevation Myocardial Infarction -Results of the CASSIOPEIA study-
Predictive Ability and Efficacy for Shortening Door-to-balloon Time of a New Prehospital Electrocardiogram-transmission Flow Chart in Patients with ST-elevation Myocardial Infarction -Results of the CASSIOPEIA study-
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新的院前心电图传输流程图对 ST 段抬高型心肌梗死患者缩短门到球囊时间的预测能力和功效 -CASSIOPEIA 研究结果 -
DOI：
10.1016/j.jjcc.2018.03.011
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发表时间：
2018
影响因子：
2.5
通讯作者：
Itoh T
中科院分区：
文献类型：
--
作者：
Sakai T;Nishiyama O; Onodera M; Matsuda S;Wakisawa S; Nakamura M;Morino Y; Itoh T
背景本研究的目的是建立一种新的院前心电图（ECG）传输流程图，评估其对ST段抬高型心肌梗死（STEMI）的预测能力，并缩短门到球囊时间（DTBT）。共4090例紧急转移到我院的连续患者被分为两组：在救护车上使用新流程图的心电图传输设备（ECGT-FC）和在救护车上不使用心电图传输设备（non-ECGT）组。STEMI组包括在同一时期的步行患者被用作对照组。评价新的心电图传输流程对ST段抬高型心肌梗死的预测能力及缩短DTBT的有效性。在ECGT-FC组中，通过新流程图心电图传输的STEMI患病率显著高于非心电图传输患者（6.71% vs.0.19%;p< 0.001）。新的心电图传输流程图的敏感性和特异性分别为83.3%和88.1%。中位DTBT显著缩短（p= 0.045）和DTBT < 90分钟的患病率在ECGT-FC组中显著高于其他groups.ConclusionThe敏感性和特异性的心电图传输的新流程图是高的。新流程结合心电图传输装置可有效检测STEMI，缩短DTBT。
BackgroundThe purposes of this study were to create a new flow-chart of prehospital electrocardiography (ECG)-transmission, evaluate its predictive ability for ST-elevation myocardial infarction (STEMI) and shorten door-to-balloon time (DTBT).Method and resultsThe new transmission flow-chart was created using symptoms from previous medical records of STEMI patients. A total of 4090 consecutive patients transferred emergently to our hospital were divided into two groups: those in ambulances with an ECG-transmission device with the new flow-chart (ECGT-FC) and those transferred without an ECG-transmission device (non-ECGT) groups. A STEMI group comprising walk-in patients during the same period was used as a control group. The predictive ability of STEMI and the effectiveness of shortening the DTBT by the new flow-chart of ECG-transmission was evaluated. In the ECGT-FC group, the prevalence of STEMI in the ECG-transmission by the new flow-chart were significantly higher than in the non-ECG-transmission patients (6.71% vs. 0.19%;p< 0.001). The sensitivity and specificity of the new ECG-transmission flow-chart were 83.3% and 88.1%, respectively. The median DTBT was significantly shortened (p= 0.045) and the prevalence of DTBT < 90 min was significantly higher in the ECGT-FC group (p= 0.018) than the other groups.ConclusionThe sensitivity and specificity of the new flow-chart for ECG-transmission were high. The new flow-chart combined with an ECG-transmission device could detect STEMI efficiently and shorten DTBT.