Pushing the Envelope on STEMI Response.

New findings from the Mission: Lifeline STEMI Systems Accelerator program suggest that a regionalized approach to ST-segment elevation myocardial infarctions (STEMI) can cut time-to-treatment for patients modestly, thereby improving the prospects for better outcomes. The approach encourages hospitals, emergency medical services (EMS) and cardiologists in a region to work together to optimize treatment and efficiency so that patients in need of percutaneous coronary intervention (PCI) receive this care more expeditiously. The research included 484 hospitals, 1,253 EMS agencies, and nearly 24,000 patients in 16 regions across the United States. The goal was to increase the number of STEMI patients who receive PCI bed time parameters. Overall, the percentage of STEMI patients receiving PCI in accordance with guidelines improved from 50% to 55% during the study period. Key to the Mission: Lifeline approach is a focus on starting the clock ticking on time-to-treatment at first medical contact (FMC) as opposed to the hospital door, but this requires coordination with EMS and other hospitals. Some observers question whether a push for regionalization is worth the effort, considering the modest results thus far.

Duke Scholars

Author Christopher Bull Granger Medicine, Cardiology