Treatment delays in patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction at the Quebec Heart and Lung Institute
Treatment delays in patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction at the Quebec Heart and Lung Institute
复制标题
DOI：
10.1016/s0828-282x(07)71011-5
复制
发表时间：
2007-10-01
影响因子：
6.2
通讯作者：
de Larochelliere, Robert
中科院分区：
文献类型：
--
作者：
Garceau, Patrick;Dery, Jean-Pierre;de Larochelliere, Robert
背景：当前 ST 段抬高型心肌梗死 (STEMI) 指南建议在到达医院后 90 分钟内进行直接经皮冠状动脉介入治疗 (PCI)。然而，最近的数据表明，在现实环境中，转运患者的中位门到球囊 (DTB) 时间接近 180 分钟，不到 5% 的患者在 90 分钟内接受治疗。进行了一项回顾性观察研究，以评估在魁北克心肺研究所 (QHLI) 接受直接 PCI 的患者的治疗时间。 方法：2004 年 4 月至 2005 年 3 月期间，因 STEMI 在 QHLI 连续接受溶栓资格的 STEMI 患者纳入本分析。主要评估是从到达第一家医院到第一次气球充气的 DTB 时间。临床结果为院内死亡、再梗死和出血。将从转诊医院转移的患者的 DTB 时间和医院结果与直接到 QHLI 就诊的患者进行比较。 结果：在研究期间，203 名符合溶栓资格的患者接受了直接 PCI 治疗。 69 名患者直接到 QHLI 就诊，134 名患者是从其他医院转来的。由于缺少时间变量，六名转移患者被排除在外。转院患者的中位 DTB 时间为 114 分钟，而直接向 QHLI 就诊的患者为 87 分钟（P
BACKGROUND: Current guidelines for ST elevation myocardial infarction (STEMI) recommend performing primary percutaneous coronary intervention (PCI) within 90 min of hospital arrival. However, recent data suggest that in a real-world setting, median door-to-balloon (DTB) time is closer to 180 min for transfer patients, with less than 5% of patients being treated within 90 inin. A retrospective observational study was conducted to assess time to treatment in patients undergoing primary PCI at the Quebec Heart and Lung Institute (QHLI).METHODS: Consecutive lytic-eligible patients undergoing primary PCI at the QHLI for STEMI between April 2004 and March 2005 were included in the present analysis. The primary evaluation was DTB time measured from arrival at the first hospital to first balloon inflation. Clinical outcomes were in-hospital death, reinfarction and bleeding. DTB times and hospital outcomes of patients transferred from referring hospitals were compared with those of patients presenting directly to the QHLI.RESULTS: During the study period, 203 lytic-eligible patients were treated with primary PCI. Sixty-nine patients presented directly to the QHLI and 134 were transferred from other hospitals. Six transfer patients were excluded because of missing time variables. The median DTB time was 114 min in transfer patients, compared with 87 min in patients presenting directly to the QHLI (P