Details

Autor(en) / Beteiligte

• Le May, Michel R
• So, Derek Y
• Dionne, Richard
• Glover, Chris A
• Froeschl, Michael P.V
• Wells, George A
• Davies, Richard F
• Sherrard, Heather L
• Maloney, Justin
• Marquis, Jean-François
• O'Brien, Edward R
• Trickett, John
• Poirier, Pierre
• Ryan, Sheila C
• Ha, Andrew
• Joseph, Phil G
• Labinaz, Marino

Titel

A Citywide Protocol for Primary PCI in ST-Segment Elevation Myocardial Infarction

Ist Teil von

• The New England journal of medicine, 2008-01, Vol.358 (3), p.231-240

Ort / Verlag

Boston, MA: Massachusetts Medical Society

Erscheinungsjahr

2008

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals

Beschreibungen/Notizen

• To minimize door-to-balloon times, Ottawa developed a program in which patients with ST-elevation myocardial infarction were taken directly from the field to a cardiac care center for primary coronary angioplasty. The median door-to-balloon time (69 minutes) was approximately half that of patients who were transferred from emergency departments (123 minutes). Respective in-hospital mortality rates were 3.0% and 5.7% (P=0.30). Ottawa developed a program in which patients with ST-elevation myocardial infarction were taken directly from the field to a cardiac care center for primary coronary angioplasty. The median door-to-balloon time (69 minutes) was approximately half that of patients who were transferred from emergency departments (123 minutes). Survival of patients presenting with ST-segment elevation myocardial infarction is enhanced by rapid, complete, and sustained reperfusion of the infarct-related artery. 1 – 3 Delays in either door-to-needle 1 or door-to-balloon 4 – 7 times are associated with increased mortality. In patients who are treated with primary percutaneous coronary intervention (PCI), each 30 minutes of delay increases the relative risk of 1-year mortality by 7.5%. 6 It has been recommended that efforts be made to shorten door-to-balloon times for all patients because time-to-balloon strongly correlates with mortality regardless of the baseline risk of mortality. 7 PCI ensures more complete and sustained restoration of flow to the infarct-related . . .