Universität zu Köln

Pfister, Roman, Lee, Samuel, Kuhr, Kathrin, Baer, Frank, Fehske, Wolfgang, Hoepp, Hans-Wilhelm, Baldus, Stephan and Michels, Guido (2016). Impact of the Type of First Medical Contact within a Guideline-Conform ST-Elevation Myocardial Infarction Network: A Prospective Observational Registry Study. PLoS One, 11 (6). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Aims The impact of type of first medical contact (FMC) in the setting of a guideline conform metropolitan ST-elevation myocardial infarction (STEMI) network providing obligatory primary percutaneous coronary intervention (PCI) is unclear. Methods and Results 3,312 patients were prospectively included between 2006 and 2012 into a registry accompanying the Cologne Infarction Model STEMI network, with 68.4% primarily presenting to emergency medical service (EMS), 17.6% to non-PCI-capable hospitals, and 14.0% to PCI-capable hospitals. Median contact-to-balloon time differed significantly by FMC with 89 minutes (IQR 72-115) for EMS, 107 minutes (IQR 85-148) for non-PCI- and 65 minutes (IQR 48-91) for PCI-capable hospitals (p < 0.001). TIMI-flow grade III and in-hospital mortality were 75.7% and 10.4% in EMS, 70.3% and 8.6% in non-PCI-capable hospital and 84.4% and 5.6% in PCI-capable hospital presenters, respectively (p both < 0.01). The association of FMC with in-hospital mortality was not significant after adjustment for baseline characteristics, but risk of TIMI-flow grade < III remained significantly increased in patients presenting to non-PCI-capable hospitals. Conclusion Despite differences in treatment delay by type of FMC in-hospital mortality did not differ significantly. The increased risk of TIMI-flow grade < III in patients presenting to non PCI-capable hospitals needs further study.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Samuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Baer, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Fehske, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoepp, Hans-Wilhelm UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-272462
DOI:	10.1371/journal.pone.0156769
Journal or Publication Title:	PLoS One
Volume:	11
Number:	6
Date:	2016
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PERCUTANEOUS CORONARY INTERVENTION; TO-BALLOON TIME; SEGMENT-ELEVATION; PRIMARY PCI; PRIMARY ANGIOPLASTY; STEMI REGISTRY; MORTALITY; STRATEGIES; OUTCOMES; IMPLEMENTATION Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27246