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Heart attack victims who have ECGs in the field experience shorter time-to-treatment
Date:1/20/2010

A recent study found that individuals experiencing chest pain who had electrocardiogram (ECG or EKG) assessments prior to arriving at the hospital experienced a significantly reduced time-to-treatment or door-to-balloon (D2B) time. When EMS personnel responding to cardiac emergencies obtained ECGs of the subjects in the field, the mean D2B time was 60.2 minutes compared with 90.5 minutes for in-hospital ECGs. This advanced assessment significantly reduced D2B by allowing patients to bypass the ER and be transported directly to the cardiac catheterization laboratory (CCL) for reperfusion treatment. Details of the study appear in the January 2010 issue of Catheterization and Cardiovascular Interventions, published by Wiley-Blackwell on behalf of The Society for Cardiovascular Angiography and Interventions.

ST-segment elevation myocardial infarction (STEMI), when a blood clot totally obstructs a coronary artery, is treated with reperfusion therapy to reestablish blood flow as quickly as possible. Prior studies showed that rapid time-to-treatment with primary percutaneous coronary intervention (PPCI), previously known as angioplasty, was associated with lower mortality rates, and for each 30 minutes of delay the relative risk of 1 year mortality increased by 7.5%. In an effort to improve patient survival rates, the American College of Cardiology (ACC) and the American Heart Association (AHA) developed national guidelines that state hospitals treating STEMI patients with PPCI should strive to achieve a median door-to-balloon time of less than 90 minutes.

The research team, led by Shukri David, M.D., FSCAI from Providence Hospital and Medical Center, conducted a prospective, observational study of D2B time in three hospitals in Southeast Michigan from October 1, 2003 through April 30, 2008. At each center, a protocol was initiated, where EMS personnel obtained a 12-lead ECG during initial assessment in the field from patients with symp
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Contact: Dawn Peters
medicalnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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