Treatment delays in patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction at the Quebec Heart and Lung Institute.

  • Garceau P
  • Dery J
  • Lachance P
 et al. 
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BACKGROUND: Current guidelines for ST elevation myocardial infarction (STEMI) recommend performing primary percutaneous coronary intervention (PCI) within 90 min of hospital arrival. However, recent data suggest that in a real-world setting, median door-to-balloon (DTB) time is closer to 180 min for transfer patients, with less than 5% of patients being treated within 90 min. A retrospective observational study was conducted to assess time to treatment in patients undergoing primary PCI at the Quebec Heart and Lung Institute (QHLI). METHODS: Consecutive lytic-eligible patients undergoing primary PCI at the QHLI for STEMI between April 2004 and March 2005 were included in the present analysis. The primary evaluation was DTB time measured from arrival at the first hospital to first balloon inflation. Clinical outcomes were in-hospital death, reinfarction and bleeding. DTB times and hospital outcomes of patients transferred from referring hospitals were compared with those of patients presenting directly to the QHLI. RESULTS: During the study period, 203 lytic-eligible patients were treated with primary PCI. Sixty-nine patients presented directly to the QHLI and 134 were transferred from other hospitals. Six transfer patients were excluded because of missing time variables. The median DTB time was 114 min in transfer patients, compared with 87 min in patients presenting directly to the QHLI (P

Author-supplied keywords

  • Aged
  • Angioplasty, Balloon, Coronary
  • Cardiology
  • Female
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Hospitals, Community
  • Humans
  • Male
  • Medicine
  • Middle Aged
  • Myocardial Infarction
  • Patient Transfer
  • Quebec
  • Retrospective Studies
  • Specialization
  • Time Factors
  • Treatment Outcome
  • therapy
  • trends

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  • Patrick Garceau

  • Jean-Pierre Dery

  • Philippe Lachance

  • Stefanie Grenier

  • Josep Rodes-Cabau

  • Gerald Barbeau

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