Navigation Links
Statewide program helps improve quality of care for heart attack
Date:11/4/2007

Implementation of a program in North Carolina to increase the rate of coronary reperfusion (restoring blood flow to the heart muscle) for heart attack significantly improved the quality of care these patients received, according to a study in JAMA being released early online to coincide with its release at the American Heart Associations annual meeting. The study will be published in the November 28 print issue of JAMA.

ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram during a heart attack) is a potentially lethal condition for which specific therapies, administered rapidly, can reduce the risk of death and illness. Despite more than two decades of clinical trial evidence demonstrating significant benefits from prompt coronary reperfusion, registries continue to show that most patients are still treated too slowly for reperfusion to be of maximal benefit, and many are not treated at all, according to background information in the article. The reasons for this are largely related to systematic barriers.

James G. Jollis, M.D., of Duke University, Durham, N.C., and colleagues conducted a study to determine if establishment of a coordinated statewide system of reperfusion therapy for STEMI (Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments [RACE] study), as exists for trauma, would overcome systematic barriers and both decrease delays in administering reperfusion therapy and increase the frequency with which reperfusion was provided to eligible patients. The researchers focused on the coordination of each aspect of care from the initial emergency medical response to reperfusion itself, whether is was fibrinolytic therapy (medication for dissolving blood clots) or primary percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open blocked coronary arteries), whichever was most appropriate for a given setting.

The study included 65 hospitals and associated emergency medical systems (10 PCI hospitals and 55 non-PCI hospitals) in five regions in North Carolina, and 1,164 patients with STEMI (579 pre-intervention, 585 post-intervention) eligible for reperfusion who were treated at PCI hospitals; and 925 patients with STEMI (518 pre-intervention, 407 post-intervention) who were treated at non-PCI hospitals. The authors examined the reperfusion times and rates three months before (July September 2005) and three months after (January March 2007) a year-long implementation.

Among patients presenting to PCI hospitals who underwent primary PCI, the proportion with first door-to-device times less than 90 minutes increased from 57 percent to 72 percent with a decrease in median (midpoint) time from 85 to 74 minutes. For patients transferred from a non-PCI hospital to another hospital for primary PCI, median time from first door-to-device declined from 165 minutes to 128 minutes. For patients presenting to the 55 non-PCI hospitals, median door-in to door-out times decreased from 120 minutes to 71 minutes. Reperfusion times also improved for door-to-needle times in non-PCI hospitals (35 to 29 minutes).

For patients treated at or transferred to PCI hospitals, clinical outcomes including death, cardiac arrest, and cardiogenic shock did not significantly change following the intervention, although the study was not designed to directly assess these outcomes.

We have demonstrated that a statewide program focused on the development of regional systems for STEMI reperfusion can significantly improve quality of care. Further research is needed to ensure that this and other programs that demonstrate improvement in application of reperfusion therapies lead to reduced mortality and morbidity from acute myocardial infarction, the authors conclude.


'/>"/>

Contact: Michelle Gailiun
919-724-5343
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Another Statewide Organization Joins the Fight Against Assisted Suicide
2. Computer Program can assist to detect Heart Attack
3. Advanced STD programs required
4. Self-Management Program Beneficial for Back Pain
5. Self-Management Program Beneficial for Back Pain
6. Disease Management Programs – Effective for Heart Patient
7. Suicide Prevention Program – Having its Intended Effec
8. Cardiac – Rehabilitation Programs Beneficial for Heart Patient
9. Pulmonary rehabilitation program effective for chronic obstructive pulmonary disease
10. New Healthy Weight Program Makes Healthy Eating More Interesting
11. The Potential Of Cadaver Transplantation Programme In India
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/20/2017)... ... 2017 , ... Chuck E. Cheese’s® and Center for Autism and Related Disorders ... E. Cheese’s locations throughout New England, New York and New Jersey to provide children ... fun of visiting Chuck E. Cheese’s in a sensory-friendly environment. , After a ...
(Date:2/19/2017)... ... , ... ProBrand Glitch is a set of 30 glitch distortion logo reveals made exclusively for ... logo with a glitch reveal in just a few clicks of a mouse. Customizable glitch ... each preset. Use these presets to add a uniquely animated logo to any photos or ...
(Date:2/18/2017)... ... 2017 , ... Butler Mobility invited Ken Matthews to visit its manufacturing facility ... Ken was impressed with the safety and reliability of the Stannah Stairlift as well ... This endorsement by Ken Matthews can be heard on News Radio WHP 580 ...
(Date:2/17/2017)... ... , ... Smiles by Seese is a comprehensive family dental practice ... the practice as a skilled and highly credentialed dentist who is qualified to perform ... of all ages with excellence in general, restorative, and cosmetic dentistry . Their ...
(Date:2/17/2017)... (PRWEB) , ... February 17, ... ... Device Approval and Reimbursement , **An FDAnews Webinar**, Feb. 22, 2017 — ... are the critical reimbursement questions manufacturers should be asking before selecting an ...
Breaking Medicine News(10 mins):
(Date:2/20/2017)... February 20, 2017 The ... anticipated to reach USD 1.4 billion by 2022, ... Research, Inc. Constant evaluation of various techniques by ... to drive growth in this market. Moreover, shunt ... of novel and improved shunts in order to ...
(Date:2/20/2017)... COTTAGE, New York , February 20, 2017 /PRNewswire/ ... a regularized absorption of calcium and phosphorous minerals in ... role of vitamin D ingredients in maintaining a healthy ... or medicines containing vitamin D ingredients is growing in ... the advantage of consuming vitamin D ingredients for treatment ...
(Date:2/19/2017)... --  AC Group Inc. , a leading company, specializing ... the PMS/EHR healthcare marketplace, will exhibit the 7 Stages ... in this ecosystem at HIMSS,17. ... over 200 ACOs, compared and analyzed an ACO,s needs ... are providing different pieces of Population Health technologies designed ...
Breaking Medicine Technology: