Introduction: The outcome of patients with acute ST elevation myocardial infarction (STEMI) is strongly related to the time interval from hospital entry to time of primary percutaneous coronary intervention (PPCI). Current guidelines recommend a door to balloon time of
Objective: We performed a comprehensive intervention program to reduce the time from hospital admission to PPCI and to increase the percentage of patients treated within 90 minutes.
Methods: In March 2013 we launched a seven components intervention program: 1. Education program for the emergency department staff. 2. Emphasize the urgency to have a decision regarding PPCI. 3. Catheterization team activation by a single phone call 4. On-call staff arrival to hospital by private cars. 5. Direct patient evacuation by emergency medical services to the cardiology division and catheterization laboratory. 6. Standardization of the medical records. 7. Case investigation and feedback.
We report 14 month prior and 18 months after initiating our intervention program. We compared the mean and median time from hospital admission to PPCI and the percentage of patients treated within 90 minutes before and after initiating our the intervention.
Results: Between 1.1.2012 and 28.2.2013, the pre-intervention phase, we treated a total of 133 patients with STEMI by PPCI whereas during the after intervention phase between 1.3.2013 and 31.8.2014 – we treated 200 patients with STEMI by PPCI. The mean/median time to treatment for the pre-intervention and post-intervention periods was 126/67 and 52/47 minutes respectively (p< 0.01). The percentage of patients treated within 90 minutes before and after the intervention was 65% and 90% respectively (p< 0.01).
Conclusion: With a comprehensive intervention program we were able to significantly shorten the time from hospital admission to PPCI of STEMI patients and to increase the percentage of patients treated within 90 minutes.
