Abstract
Background: We have had a “one call activation system” for primary PCI at our regional academic center since 1999. The ED physician initiated the system with the decision for primary PCI made by cardiologist (interventional or non-interventional) on call. But since July 1, 2009, only interventional cardiologists are involved in the decision making process. Otherwise, the comprehensive strategy remained the same. As we have reported previously, this new strategy resulted in a shortened door-to-balloon (D2B) time. In the present study, we analyzed the D2B timeline intervals to determine where the major gains were achieved. Methods: We conducted a retrospective analysis of 665 consecutive patients presenting to our institution with suspicion of acute STEMI during a 30-month period. Group 1 consisted of patients in the 12 months (July 1 2008-June 30 2009) before and Group 2 consisted of patients in the 18 months (July 1 2009-Dec. 31 2010) after the system change was instituted. Mann-Whitney U test and chi-square test were used for statistical analysis. Results: 218 patients in group 1 were taken to the cath lab of which 180 received primary PCI. 349 patients in group 2 were taken to the cath lab of which 275 received primary PCI. The results were presented in the table. Conclusions: Comprehensive strategy with exclusive involvement of interventional cardiologist resulted in a significant decrement in decision-to-balloon time. The EKG-to-decision time did not decrease, contrary to our expectation.
Published Version
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