Abstract 16067: The Impact of a Prehospital Mobile Cloud ECG Transmission System on Myocardial Damage and Mid-Term Mortality in Patients With ST-Elevation Myocardial Infarction

Abstract

Background: Guidelines recommend that the door-to-balloon time (DTBT) should be reduced to ninety minutes or less in patients with STEMI. As such, it is critical that ambulance teams are adequately trained and equipped to identify STEMI utilizing ECG recorders and telemetry when necessary. Aims: This single-center study aims to evaluate the impact of the prehospital mobile cloud 12-lead ECG transmission system (SCUNA ® , MEHERGEN GROUP) on reducing DTBT, myocardial damage, and mortality in STEMI patients. Methods: In June 2018, SCUNA were integrated into the regional emergency medical service (EMS) departments in Uki and Kamimashiki cities in Kumamoto, Japan. We examined and compared door-to-catheterization laboratory time (DTCT), DTBT, peak CK, CK-MB levels, as well as 1-year mortality rates of STEMI cases in the four years before and after the introduction of the SCUNA. From June 2014 to May 2022, a total of 338 STEMI patients were transferred to our institute by ambulances from the two EMS departments. After excluding 29 patients with onset to reperfusion times exceeding 24 hours and 66 patients who were transferred without the use of SCUNA following its introduction, 243 consecutive STEMI patients who underwent emergency percutaneous coronary intervention (PCI) were included in the study. The patients were divided into two groups, 130 patients prior to SCUNA introduction (Pre-SCUNA), 113 patients after SCUNA introduction (Post-SCUNA). Results: There were no significant differences in age, gender, past medical history or Killip classification between the two groups. DTCT, DTBT, and onset to reperfusion time (OTRT) were significantly reduced in the Post-SCUNA group compared to the Pre-SCUNA group (Pre-SCUNA: 40 min vs. Post-SCUNA: 25 min; p < 0.01, 71 min vs. 53 min; p < 0.01, and 201 min vs. 166 min; p = 0.02, respectively). No significant differences were observed between peak CK and CK-MB levels in the two groups. Kaplan-Meier analysis revealed that SCUNA did not improve 30-day and 1-year outcomes compared with the Pre-SCUNA groups. Conclusion: While the prehospital mobile cloud ECG transmission system effectively reduced DTBT, it did not lead to a notable reduction in myocardial damage or mortality rates.