Impacts of establishment of chest pain center on the door-to-balloon time and the short-term outcome after primary percutaneous coronary intervention of patients with ST segment elevated myocardial infarction
10.3760/cma.j.issn.0253-3758.2013.07.011
- VernacularTitle:建立规范化胸痛中心对直接经皮冠状动脉介入治疗患者进门-球囊扩张时间及预后的影响
- Keywords:
Myocardial infarction;
Angioplasty,transluminal,percutaneous coronary;
Physician's practice patterns
- From:
Chinese Journal of Cardiology
2013;41(7):568-571
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impact of the establishment of chest pain center (CPC) model based on the pre-hospital real-time tele-12-1ead electrocardiogram on the door-to-balloon (D-to-B) time and short-term outcome after primary percutaneous coronary intervention (PPCI) of patients with ST-segment elevated myocardial infarction (STEMI).Methods A regular CPC was established with prehospital transmitted real-time 12-lead electrocardiogram system for pre-hospital diagnosis of STEMI and enabled the STEMI patients to bypass the emergency room and directly treated in the catheter lab to shorten the D-to-B time.The mean D-to-B time,the short-term outcome and medical costs were compared in PPCI patients before (93 cases,group A) and after (149 cases,group B) the establishment of CPC.Results After the establishment of CPC,the annual mean D-to-B time was significantly shortened [(127 ± 79) min in group A vs.(72 ± 23)min in group B,P ＜ 0.01],the shortest monthly mean D-to-B time was remarkably reduced in group B than in group A [(56 ± 11) min vs.(73 ± 14) min,P ＜ 0.01].The annual ratio of D-to-B below 90 minutes was significantly increased from 62.4％ (58/93) in group A to 91.9％ (137/149) in group B (P ＜0.05).The in-hospital mortality rate tended to be lower and the incidence of heart failure during hospitalization was significantly reduced in group B compared with group A [3.4％ (5/149) vs.6.5％ (6/93),P ＞ 0.05 ; 14.1％ (21/149) vs.24.7％ (23/93),P ＜ 0.05].The length of hospital stay was slightly shortened from (8.98 ± 4.89) days to (7.79 ± 5.43) days (P ＞ 0.05).Corrected mean medical cost went down by 9.4％ (P ＜ 0.05).Conclusion The establishment of CPC may significantly shorten the D-to-B time,improve the short-term outcome and reduce the hospitalization cost for PPCI patients with STEMI.
