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To evaluate the relation between residential distance and total ischaemic time in patients with acute ST-elevation myocardial infarction (STEMI).
STEMI patients were transported to the Isala Hospital Zwolle with the intention to perform primary percutaneous coronary intervention PCI (pPCI) from 2004 until 2010 (n = 4149). Of these, 1424 patients (34 %) were referred via a non-PCI ‘spoke' centre (‘spoke’ patients) and 2725 patients (66 %) were referred via field triage in the ambulance (ambulance patients).
A longer residential distance increased median total ischaemic time in ‘spoke’ patients (0–30 km: 228 min, >30-60 km: 235 min, >60-90 km: 264 min, p < 0.001), however not in ambulance patients (0–30 km: 179 min, >30-60 km: 175 min, >60-90 km: 186 min, p = 0.225). After multivariable linear regression analysis, in ‘spoke’ patients residential distance of >30-60 km compared with 0–30 km was not independently associated with ischaemic time; however, a residential distance of >60-90 km (exp (B) = 1.11, 95 % CI 1.01-1.12) compared with 0–30 km was independently related with ischaemic time. In ambulance patients, residential distance of >30-60 and >60-90 km compared with 0–30 km was not independently associated with ischaemic time.
A longer distance from the patient’s residence to a PCI centre was associated with a small but significant increase in time to treatment in ‘spoke’ patients, however not in ambulance patients. Therefore, referral via field triage in the ambulance did not lead to a significant increase in time to treatment, especially at long distances (up to 90 km).
Liem SS, Van der Hoeven BL, Oemrawsingh PV, et al. MISSION: Optimization of acute and chronic care for patients with acute MI. Am Heart J. 2007;153:14.e1-11.
Liem AL. van ’t Hof AWJ, Hoorntje JCA, de Boer MJ, Suryapranata H, Zijlstra F. Influence of treatment delay on infarct size and clinical outcome in patients with acute myocardial infarction treated with primary angioplasty. J Am Coll Cardiol. 1998;32:629–33.
Terkselsen CJ, Lassen JF, Nørgaard BJ, et al. Reduction of treatment delay in patients with ST-elevated myocardial infarction: impact of pre hospital diagnosis and direct referral to primary coronary intervention. Eur Heart J. 2005;26:770–7. CrossRef
Terkelsen CJ, Nørgaard BJ, Lassen JF, Andersen HR. Prehospital evaluation in ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention. J Electrocard. 2005;38:187–92. CrossRef
Clemmensen P, Sejersten M, Sillesen M, Hampton D, Wagner GS, Loumann-Nielsen S. Diversion of ST-elevation myocardial infarction patients for primary angioplasty based on wireless prehospital 12-lead electrocardiographic transmission directly to the cardiologist’s handheld computer: a progress report. J Electrocard. 2005;38:194–8. CrossRef
Pereira A, Niggebrugge A, Powles J, Kanka D, Lyratzopoulos G. Potential generation of geographical inequities by the introduction of primary percutaneous coronary intervention for the management of ST segment elevation myocardial infarction. Int J Health Geogr. 2007;6:43. PubMedCrossRefPubMedCentral
Novak K, Ribicic KN, Peric I, Batinic T, Ribicic I, Stula I. Impact of late hospital admission on the prognosis of patients with acute myocardial infarction. Coll Antropol. 2012;36:813–9. PubMed
Estevex-Loureiro R, Calvino-Santos R, Vazquez-Rodrigues JM, et al. Direct transfer of ST-elevation myocardial infarction patients for primary percutaneous coronary intervention from short and long transfer distances decreases temporal delays and improves short-term prognosis: the PROGALIAM Registry. EuroIntervention. 2010;6:343–9. CrossRef
Van ’t Hof AWJ, Liem A, de Boer MJ, Zijlstra F. Clinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction. Lancet. 1997;350:615–9.
- The influence of residential distance on time to treatment in ST-elevation myocardial infarction patients
J. H. E. Dambrink
M. J de Boer
A. T. M. Gosselink
J. P. Ottervanger
P. C. Koopmans
J. M. ten Berg
A. W. J. van ’t Hof
- Bohn Stafleu van Loghum