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de Diego O, Rueda F, Carrillo X, Oliveras T, Andrea R, El Ouaddi N, Serra J, Labata C, Ferrer M, Martínez-Membrive MJ, Montero S, Mauri J, García-Picart J, Rojas S, Ariza A, Tizón-Marcos H, Faiges M, Cárdenas M, Lidón RM, Muñoz-Camacho JF, Jiménez Fàbrega X, Lupón J, Bayés-Genís A, García-García C. Performance analysis of a STEMI network: prognostic impact of the type of first medical contact facility. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:708-718. [PMID: 36623690 DOI: 10.1016/j.rec.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION AND OBJECTIVES Prognosis in ST-elevation myocardial infarction (STEMI) is determined by delay in primary percutaneous coronary intervention (PPCI). The impact of first medical contact (FMC) facility type on reperfusion delays and mortality remains controversial. METHODS We performed a prospective registry of primary coronary intervention (PCI)-treated STEMI patients (2010-2020) in the Codi Infart STEMI network. We analyzed 1-year all-cause mortality depending on the FMC facility type: emergency medical service (EMS), community hospital (CH), PCI hospital (PCI-H), or primary care center (PCC). RESULTS We included 18 332 patients (EMS 34.3%; CH 33.5%; PCI-H 12.3%; PCC 20.0%). Patients with Killip-Kimball classes III-IV were: EMS 8.43%, CH 5.54%, PCI-H 7.51%, PCC 3.76% (P <.001). All comorbidities and first medical assistance complications were more frequent in the EMS and PCI-H groups (P <.05) and were less frequent in the PCC group (P <.05 for most variables). The PCI-H group had the shortest FMC-to-PCI delay (median 82 minutes); the EMS group achieved the shortest total ischemic time (median 151 minutes); CH had the longest reperfusion delays (P <.001). In an adjusted logistic regression model, the PCI-H and CH groups were associated with higher 1-year mortality, OR, 1.22 (95%CI, 1.00-1.48; P=.048), and OR, 1.17 (95%CI 1.02-1.36; P=.030), respectively, while the PCC group was associated with lower 1-year mortality than the EMS group, OR, 0.71 (95%CI 0.58-0.86; P <.001). CONCLUSIONS FMC with PCI-H and CH was associated with higher adjusted 1-year mortality than FMC with EMS. The PCC group had a much lower intrinsic risk and was associated with better outcomes despite longer revascularization delays.
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Affiliation(s)
- Oriol de Diego
- Servicio de Cardiología, Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Doctorando, Programa de doctorado, Department de Medicina, Universitat Autònoma de Barcelona, Spain.
| | - Ferran Rueda
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Xavier Carrillo
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Teresa Oliveras
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Rut Andrea
- Servicio de Cardiología, Institut Clínic Cardiovascular, Hospital Clínic Barcelona, Barcelona, Spain; Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Nabil El Ouaddi
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Jordi Serra
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Carlos Labata
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Marc Ferrer
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - María J Martínez-Membrive
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Santiago Montero
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Josepa Mauri
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Servei Català de Salut, Generalitat de Catalunya, Registre del Codi Infart, Barecelona, Spain
| | - Joan García-Picart
- Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Sergio Rojas
- Servicio de Cardiología, Hospital Joan XXIII, Tarragona, Spain
| | - Albert Ariza
- Servicio de Cardiología, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Helena Tizón-Marcos
- Servicio de Cardiología, Hospital del Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group, Instituto de investigaciones Hospital del Mar (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Marta Faiges
- Servicio de Cardiología, Hospital de Tortosa Verge de la Cinta, IISPV, Tarragona, Spain
| | - Mérida Cárdenas
- Servicio de Cardiología, Hospital Universitari Josep Trueta, Girona, Spain
| | - Rosa María Lidón
- Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | | | | | - Josep Lupón
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Antoni Bayés-Genís
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Cosme García-García
- Servicio de Cardiología, Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
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Zhang A, Rastogi R, Marsh KM, Yang B, Wu D, Kron IL, Yang Z. Topical Neck Cooling Without Systemic Hypothermia Attenuates Myocardial Ischemic Injury and Post-ischemic Reperfusion Injury. Front Cardiovasc Med 2022; 9:893837. [PMID: 35837603 PMCID: PMC9274088 DOI: 10.3389/fcvm.2022.893837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Following acute myocardial infarction (MI), irreversible damage to the myocardium can only be reduced by shortening the duration between symptom onset and revascularization. While systemic hypothermia has shown promising results in slowing pre-revascularization myocardial damage, it is resource intensive and not conducive to prehospital initiation. We hypothesized that topical neck cooling (NC), an easily implemented therapy for en route transfer to definitive therapy, could similarly attenuate myocardial ischemia-reperfusion injury (IRI). Methods Using an in vivo mouse model of myocardial IRI, moderate systemic hypothermia or NC was applied following left coronary artery (LCA) occlusion and subsequent reperfusion, at early, late, and post-reperfusion intervals. Vagotomy was performed after late NC in an additional group. Hearts were harvested to measure infarct size. Results Both hypothermia treatments equally attenuated myocardial infarct size by 60% compared to control. The infarct-sparing effect of NC was temperature-dependent and timing-dependent. Vagotomy at the gastroesophageal junction abolished the infarct-sparing effect of late NC. Cardiac perfusate isolated following ischemia had significantly reduced cardiac troponin T, HMGB1, cell-free DNA, and interferon α and β levels after NC. Conclusions Topical neck cooling attenuates myocardial IRI in a vagus nerve-dependent manner, with an effect comparable to that of systemic hypothermia. NC attenuated infarct size when applied during ischemia, with earlier initiation resulting in superior infarct sparing. This novel therapy exerts a cardioprotective effect without requiring significant change in core temperature and may be a promising practical strategy to attenuate myocardial damage while patients await definitive revascularization.
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Zhou Q, Tian W, Wu R, Qin C, Zhang H, Zhang H, Zhou S, Li S, Jin Y, Zheng ZJ. Quantity and Quality of Healthcare Professionals, Transfer Delay and In-hospital Mortality Among ST-Segment Elevation Myocardial Infarction: A Mixed-Method Cross-Sectional Study of 89 Emergency Medical Stations in China. Front Public Health 2022; 9:812355. [PMID: 35141193 PMCID: PMC8818716 DOI: 10.3389/fpubh.2021.812355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundTransfer delay provokes prolongation of prehospital time, which contributes to treatment delay that endangers patients with ST-segment elevation myocardial infarction (STEMI). A key constraint in reducing transfer delay is the shortage of emergency healthcare workers. This study was to explore the influence of the quality and quantity of healthcare professionals at emergency medical stations on transfer delay and in-hospital mortality among STEMI patients.MethodsA cross-sectional study using mixed methods was conducted at 89 emergency stations in 9 districts in China's Shenzhen province. Based on a sample of 31 hospitals, 1,255 healthcare professionals, and 3,131 patients with STEMI, a generalized linear model was used to explore the associations between the quality and quantity of healthcare professionals and transfer delay and in-hospital mortality among STEMI patients. Qualitative data were collected and analyzed to explore the reasons for the lack of qualified healthcare professionals at emergency medical stations.ResultsThe analysis of the quantity of healthcare professionals showed that an increase of one physician per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 5.087 min (95% CI −6.722, −3.452; P < 0.001). An increase of one nurse per 100,000 individuals was associated with decreased transfer delay by 1.471 min (95% CI −2.943, 0.002; P=0.050). Analysis of the quality of healthcare professionals showed that an increase of one physician with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay for patients with STEMI by 8.508 min (95% CI −10.457, −6.558; P < 0.001). An increase of one nurse with an undergraduate degree per 100,000 individuals was associated with decreased transfer delay by 6.645 min (95% CI −8.218, −5.072; P < 0.001). Qualitative analysis illustrated that the main reasons for low satisfaction of healthcare professionals at emergency medical stations included low income, limited promotion opportunities, and poor working environment.ConclusionsThe quantity and quality of emergency healthcare professionals are key factors influencing transfer delay in STEMI patients. The government should increase the quantity of healthcare professionals at emergency medical stations, strengthen the training, and improve their performance by linking with clinical pathways to enhance job enthusiasm among emergency healthcare professionals.
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Affiliation(s)
- Qiang Zhou
- Shenzhen Center for Prehospital Care, Shenzhen, China
| | - Wenya Tian
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, CT, United States
| | - Rengyu Wu
- Shenzhen Center for Prehospital Care, Shenzhen, China
| | - Chongzhen Qin
- Shenzhen Center for Prehospital Care, Shenzhen, China
| | | | - Haiyan Zhang
- Shenzhen Center for Prehospital Care, Shenzhen, China
| | - Shuduo Zhou
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health, Peking University, Beijing, China
| | - Siwen Li
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health, Peking University, Beijing, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health, Peking University, Beijing, China
- *Correspondence: Yinzi Jin
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
- Institute for Global Health, Peking University, Beijing, China
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Kang MG, Kang Y, Kim K, Park HW, Koh JS, Park JR, Hwang SJ, Ahn JH, Park Y, Jeong YH, Kwak CH, Hwang JY. Cardiac mortality benefit of direct admission to percutaneous coronary intervention-capable hospital in acute myocardial infarction: Community registry-based study. Medicine (Baltimore) 2021; 100:e25058. [PMID: 33725894 PMCID: PMC7969221 DOI: 10.1097/md.0000000000025058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/12/2021] [Indexed: 01/05/2023] Open
Abstract
Appropriate risk stratification and timely revascularization of acute myocardial infarction (AMI) are available in percutaneous coronary intervention (PCI) - capable hospitals (PCHs). This study evaluated whether direct admission vs inter-hospital transfer influences cardiac mortality in patients with AMI. This study was conducted in the PCH where the patients were able to arrive within an hour. The inclusion criteria were AMI with a symptom onset time within 24 hours and having undergone PCI within 24 hours after admission. The cumulative incidence of cardiac death after percutaneous coronary intervention was evaluated in the direct admission versus inter-hospital transfer groups. Among the 3178 patients, 2165 (68.1%) were admitted via inter-hospital transfer. Patients with ST-segment elevation myocardial infarction (STEMI) in the direct admission group had a reduced symptom onset-to-balloon time (121 minutes, P < .001). With a median period of 28.4 (interquartile range, 12.0-45.6) months, the cumulative incidence of 2-year cardiac death was lower in the direct admission group (NSTEMI, 9.0% vs 11.0%, P = .136; STEMI, 9.7% vs 13.7%, P = .040; AMI, 9.3% vs 12.3%, P = .014, respectively). After the adjustment for clinical variables, inter-hospital transfer was the determinant of cardiac death (hazard ratio, 1.59; 95% confidence interval, 1.08-2.33; P = .016). Direct PCH admission should be recommended for patients with suspected AMI and could be a target for reducing cardiac mortality.
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Affiliation(s)
- Min Gyu Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Yoomee Kang
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Kyehwan Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Hyun Woong Park
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jin-Sin Koh
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jeong Rang Park
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Seok-Jae Hwang
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jong-Hwa Ahn
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Yongwhi Park
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Young-Hoon Jeong
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Choong Hwan Kwak
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jin-Yong Hwang
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
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Masuda J, Kishi M, Kumagai N, Yamazaki T, Sakata K, Higuma T, Ogimoto A, Dohi K, Tanigawa T, Hanada H, Nakamura M, Sokejima S, Takayama M, Higaki J, Yamagishi M, Okumura K, Ito M. Rural-Urban Disparity in Emergency Care for Acute Myocardial Infarction in Japan. Circ J 2018; 82:1666-1674. [PMID: 29593169 DOI: 10.1253/circj.cj-17-1275] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There are few reports examining regional differences between rural prefectures and metropolitan areas in the management of acute myocardial infarction (AMI) in Japan.Methods and Results:In the Rural AMI registry, a prospective, multi-prefectural registry of AMI in 4 rural prefectures (Ishikawa, Aomori, Ehime and Mie), a total of 1,695 consecutive AMI patients were registered in 2013. Among them, 1,313 patients who underwent primary percutaneous coronary intervention (PPCI) within 24 h of onset were enrolled in this study (Rural group), and compared with the cohort data from the Tokyo CCU Network registry for AMI in the same period (Metropolitan group, 2,075 patients). The prevalence of direct ambulance transport to PCI-capable facilities in the Rural group was significantly lower than that in the Metropolitan group (43.8% vs. 60.3%, P<0.01), which resulted in a longer onset-to-balloon time (OTB: 225 vs. 210 min, P=0.02) and lower prevalence of PPCI in a timely fashion (OTB ≤2 h: 11.5% vs. 20.7%, P<0.01) in the Rural group. Multivariate analysis revealed that direct ambulance transport was the strongest predictor for PPCI in a timely fashion (odds ratio=4.13, P<0.001). CONCLUSIONS AMI patients in rural areas were less likely to be transported directly to PCI-capable facilities, resulting in time delay to PPCI compared with those in metropolitan areas.
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Affiliation(s)
- Jun Masuda
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | | | - Toru Yamazaki
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine
| | - Kenji Sakata
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Takumi Higuma
- Department of Cardiology, Respiratory Medicine and Nephrology, Hirosaki University Graduate School of Medicine
| | - Akiyoshi Ogimoto
- Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Hiroyuki Hanada
- Department of Cardiology, Respiratory Medicine and Nephrology, Hirosaki University Graduate School of Medicine
| | | | - Shigeru Sokejima
- Department of Public Health and Occupational Medicine, Mie University Graduate School of Medicine
| | | | - Jitsuo Higaki
- Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
| | - Masakazu Yamagishi
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine
| | - Ken Okumura
- Division of Cardiology, Saiseikai Kumamoto Hospital
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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Almawiri A, Jan V, Ziad A, Martin J, Josef S. Mortality benefit of primary transportation to a PCI-capable center persists through an eight-year follow-up in patients with ST-segment elevation myocardial infarction. J Interv Cardiol 2017; 30:522-526. [DOI: 10.1111/joic.12419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/11/2017] [Accepted: 07/18/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Abdulwasya Almawiri
- Department of Cardiovascular Medicine; University Hospital in Hradec Kralove; Charles University; Hradec Kralove Czech Republic
| | - Vojacek Jan
- Department of Cardiovascular Medicine; University Hospital in Hradec Kralove; Charles University; Hradec Kralove Czech Republic
| | - Albahri Ziad
- Department of Pediatrics; University Hospital in Hradec Kralove; Hradec Kralove Czech Republic
| | - Jakl Martin
- Department of Emergency Medicine; University Hospital in Hradec Kralove; Hradec Kralove Czech Republic
- Department of Internal Medicine; University of Defense; Faculty of Military Health Sciences; Hradec Kralove Czech Republic
| | - Stasek Josef
- Department of Cardiovascular Medicine; University Hospital in Hradec Kralove; Charles University; Hradec Kralove Czech Republic
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7
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Kodama N, Nakamura T, Yanishi K, Nakanishi N, Zen K, Yamano T, Shiraishi H, Shirayama T, Shiraishi J, Sawada T, Kohno Y, Kitamura M, Furukawa K, Matoba S. Impact of Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction Who Arrived by Self-Transport ― Acute Myocardial Infarction-Kyoto Multi-Center Risk Study Group ―. Circ J 2017. [DOI: 10.1253/circj.cj-17-0083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Naotoshi Kodama
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Takeshi Nakamura
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Kenji Yanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Naohiko Nakanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Kan Zen
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Tetsuhiro Yamano
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Hirokazu Shiraishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Takeshi Shirayama
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | | | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
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8
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Dávila FA, Pardo DA, Lewis AJ, Vargas L. Análisis de supervivencia según la oportunidad de atención en la enfermedad coronaria. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2015.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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9
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Fujita H. Redefinition of Prehospital Area as Critical Target for ST-Elevation Myocardial Infarction Care - "Time Is Myocardium". Circ J 2016; 80:1700-1. [PMID: 27430251 DOI: 10.1253/circj.cj-16-0651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University
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10
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Nakatsuma K, Shiomi H, Morimoto T, Furukawa Y, Nakagawa Y, Ando K, Kadota K, Yamamoto T, Suwa S, Horie M, Kimura T. Inter-Facility Transfer vs. Direct Admission of Patients With ST-Segment Elevation Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Circ J 2016; 80:1764-72. [PMID: 27350014 DOI: 10.1253/circj.cj-16-0204] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Inter-facility transfer for primary percutaneous coronary intervention (PCI) from referring facilities to PCI centers causes a significant delay in treatment of ST-segment elevation acute myocardial infarction (STEMI) patients undergoing primary PCI. However, little is known about the clinical outcomes of STEMI patients undergoing inter-facility transfer in Japan. METHODS AND RESULTS In the CREDO-Kyoto acute myocardial infarction (AMI) registry that enrolled 5,429 consecutive AMI patients in 26 centers in Japan, the current study population consisted of 3,820 STEMI patients who underwent primary PCI within 24 h of symptom onset. We compared long-term clinical outcomes between inter-facility transfer patients and those directly admitted to PCI centers. The primary outcome measure was a composite of all-cause death or heart failure (HF) hospitalization. There were 1,725 (45.2%) inter-facility transfer patients, and 2,095 patients (54.8%) with direct admission to PCI centers. The cumulative 5-year incidence of death/HF hospitalization was significantly higher in the inter-facility transfer patients than in those with direct admission (26.9% vs. 22.2%; log-rank P<0.001). After adjusting for potential confounders, the risk for death/HF hospitalization was significantly higher (adjusted hazard ratio: 1.22, 95% confidence interval: 1.07-1.40, P<0.001) in the inter-facility transfer patients than in those directly admitted. CONCLUSIONS Inter-facility transfer was associated with significantly worse long-term clinical outcomes for patients with STEMI undergoing primary PCI. (Circ J 2016; 80: 1764-1772).
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Affiliation(s)
- Kenji Nakatsuma
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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11
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Kawakami S, Tahara Y, Noguchi T, Yagi N, Kataoka Y, Asaumi Y, Nakanishi M, Goto Y, Yokoyama H, Nonogi H, Ogawa H, Yasuda S. Time to Reperfusion in ST-Segment Elevation Myocardial Infarction Patients With vs. Without Pre-Hospital Mobile Telemedicine 12-Lead Electrocardiogram Transmission. Circ J 2016; 80:1624-33. [DOI: 10.1253/circj.cj-15-1322] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shoji Kawakami
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yoichi Goto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hiroyuki Yokoyama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Hisao Ogawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
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Higuma T, Hanada H, Okumura K. Direct Transfer, Shorter Onset-to-Balloon Time, and Better Clinical Outcome in ST-Segment Elevation Myocardial Infarction. Circ J 2015; 79:1897-9. [DOI: 10.1253/circj.cj-15-0803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takumi Higuma
- Department of Cardiology, Hirosaki University Graduate School of Medicine
| | - Hiroyuki Hanada
- Emergency and Critical Care Center, Aomori Prefectural Central Hospital
| | - Ken Okumura
- Department of Cardiology, Hirosaki University Graduate School of Medicine
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