Inter-Facility Transfer vs. Direct Admission of Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
Inter-Facility Transfer vs. Direct Admission of Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
复制标题
DOI：
10.1253/circj.cj-16-0204
复制
发表时间：
2016-08-01
影响因子：
3.3
通讯作者：
Kimura, Takeshi
中科院分区：
文献类型：
--
作者：
Nakatsuma, Kenji;Shiomi, Hiroki;Kimura, Takeshi
背景资料：直接经皮冠状动脉介入治疗（PCI）从转诊机构到PCI中心的机构间转移导致接受直接PCI的ST段抬高急性心肌梗死（STEMI）患者的治疗显著延迟。然而，鲜为人知的是，STEMI患者进行设施间转移在Japanes.Methods和结果的临床结果：在CREDO-京都急性心肌梗死（AMI）注册登记，在日本26个中心，连续5,429例AMI患者，目前的研究人群包括3,820 STEMI患者在症状发作24小时内接受了主PCI。我们比较了机构间转移患者和直接进入PCI中心的患者的长期临床结局。主要结局指标是全因死亡或心力衰竭（HF）住院的复合指标。有1，725例（45.2%）机构间转移患者，2，095例（54.8%）直接入住PCI中心。机构间转移患者的5年死亡/HF住院累积发生率显著高于直接入院患者（26.9% vs. 22.2%;对数秩P
Background: Inter-facility transfer for primary percutaneous coronary intervention (PCI) from referring facilities to PCI centers causes a significant delay in treatment of ST-segment elevation acute myocardial infarction (STEMI) patients undergoing primary PCI. However, little is known about the clinical outcomes of STEMI patients undergoing inter-facility transfer in Japan.Methods and Results: In the CREDO-Kyoto acute myocardial infarction (AMI) registry that enrolled 5,429 consecutive AMI patients in 26 centers in Japan, the current study population consisted of 3,820 STEMI patients who underwent primary PCI within 24 h of symptom onset. We compared long-term clinical outcomes between interfacility transfer patients and those directly admitted to PCI centers. The primary outcome measure was a composite of all-cause death or heart failure (HF) hospitalization. There were 1,725 (45.2%) inter-facility transfer patients, and 2,095 patients (54.8%) with direct admission to PCI centers. The cumulative 5-year incidence of death/HF hospitalization was significantly higher in the inter-facility transfer patients than in those with direct admission (26.9% vs. 22.2%; log-rank P