Prehospital Activation of the Catheterization Laboratory Among Patients With Suspected ST-Elevation Myocardial Infarction Outside of a Hospital - Systematic Review and Meta-Analysis.
Prehospital Activation of the Catheterization Laboratory Among Patients With Suspected ST-Elevation Myocardial Infarction Outside of a Hospital - Systematic Review and Meta-Analysis.
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DOI：
10.1253/circrep.cr-22-0034
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发表时间：
2022-09-09
期刊：
影响因子：
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通讯作者：
Nonogi, Hiroshi
中科院分区：
文献类型：
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作者：
Hashiba, Katsutaka;Nakashima, Takahiro;Kikuchi, Migaku;Kojima, Sunao;Hanada, Hiroyuki;Mano, Toshiaki;Yamamoto, Takeshi;Tanaka, Akihito;Yamaguchi, Junichi;Matsuo, Kunihiro;Nakayama, Naoki;Nomura, Osamu;Matoba, Tetsuya;Tahara, Yoshio;Nonogi, Hiroshi
背景资料：在ST段抬高心肌梗死（STEMI）患者的管理中，再灌注治疗的系统延迟仍然是一个令人担忧的问题。我们调查了院前激活导管室对ST段抬高型心肌梗死患者管理的影响。方法和结果：这是一项观察性研究的系统综述。 对PubMed数据库从开始到2020年7月进行了检索，以识别纳入研究的文章。关键结局是短期和长期死亡率。重要的结局是门到球囊时间。GRADE方法用于评估证据的确定性。7项研究评估了短期死亡率; 1，541例被分配到院前激活（PH）组，1，191例被分配到急诊科激活（艾德）组。PH组每1,000名患者中死亡人数减少26人。3项研究评估了长期死亡率; 713例患者被分配到PH组，1，026例被分配到艾德组。PH组每1,000名患者中死亡人数减少54人。5项研究评估了从入院到球囊扩张的时间; 959例分配至PH组，631例分配至艾德组。PH组的门到球囊时间短33.1分钟。结论：院前启动导管插入实验室可降低医院外疑似STEMI患者的死亡率并缩短入院至球囊扩张的时间。
Background: In the management of patients with ST-elevation myocardial infarction (STEMI), system delays for reperfusion therapy are still a matter of concern. We investigated the impact of prehospital activation of the catheterization laboratory in the management of STEMI patients. Methods and Results: This is a systematic review of observational studies. A search was conducted of the PubMed database from inception to July 2020 to identify articles for inclusion in the study. The critical outcomes were short- and long-term mortality. The important outcome was door-to-balloon time. The GRADE approach was used to assess the certainty of the evidence. Seven studies assessed short-term mortality; 1,541 were assigned to the prehospital activation (PH) group and 1,191 were assigned to the emergency department activation (ED) group. There were 26 fewer deaths per 1,000 patients in the PH group. Three studies assessed long-term mortality; 713 patients were assigned to the PH group and 1,026 were assigned to the ED group. There were 54 fewer deaths per 1,000 patients among the PH group. Five studies assessed door-to-balloon time; 959 were assigned to the PH group and 631 to the ED group. Door-to-balloon time was 33.1 min shorter in the PH group. Conclusions: Prehospital activation of the catheterization laboratory resulted in lower mortality and shorter door-to-balloon time for patients with suspected STEMI outside of a hospital.