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Delay to reperfusion in patients with acute myocardial infarction presenting to acute care hospitals: an international perspective.

Publication ,  Journal Article
Spencer, FA; Montalescot, G; Fox, KAA; Goodman, SG; Granger, CB; Goldberg, RJ; Oliveira, GBF; Anderson, FA; Eagle, KA; Fitzgerald, G; Gore, JM ...
Published in: Eur Heart J
June 2010

AIMS: To examine the extent of delay from initial hospital presentation to fibrinolytic therapy or primary percutaneous coronary intervention (PCI), characteristics associated with prolonged delay, and changes in delay patterns over time in patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: We analysed data from 5170 patients with STEMI enrolled in the Global Registry of Acute Coronary Events from 2003 to 2007. The median elapsed time from first hospital presentation to initiation of fibrinolysis was 30 min (interquartile range 18-60) and to primary PCI was 86 min (interquartile range 53-135). Over the years under study, there were no significant changes in delay times to treatment with either strategy. Geographic region was the strongest predictor of delay to initiation of fibrinolysis >30 min. Patient's transfer status and geographic location were strongly associated with delay to primary PCI. Patients treated in Europe were least likely to experience delay to fibrinolysis or primary PCI. CONCLUSION: These data suggest no improvements in delay times from hospital presentation to initiation of fibrinolysis or primary PCI during our study period. Geographic location and patient transfer were the strongest predictors of prolonged delay time, suggesting that improvements in modifiable healthcare system factors can shorten delay to reperfusion therapy even further.

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Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

June 2010

Volume

31

Issue

11

Start / End Page

1328 / 1336

Location

England

Related Subject Headings

  • Young Adult
  • Time Factors
  • Thrombolytic Therapy
  • Regression Analysis
  • Patient Transfer
  • Myocardial Reperfusion
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
 

Citation

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Spencer, F. A., Montalescot, G., Fox, K. A. A., Goodman, S. G., Granger, C. B., Goldberg, R. J., … Global Registry of Acute Coronary Events (GRACE) Investigators, . (2010). Delay to reperfusion in patients with acute myocardial infarction presenting to acute care hospitals: an international perspective. Eur Heart J, 31(11), 1328–1336. https://doi.org/10.1093/eurheartj/ehq057
Spencer, Frederick A., Gilles Montalescot, Keith A. A. Fox, Shaun G. Goodman, Christopher B. Granger, Robert J. Goldberg, Gustavo B. F. Oliveira, et al. “Delay to reperfusion in patients with acute myocardial infarction presenting to acute care hospitals: an international perspective.Eur Heart J 31, no. 11 (June 2010): 1328–36. https://doi.org/10.1093/eurheartj/ehq057.
Spencer FA, Montalescot G, Fox KAA, Goodman SG, Granger CB, Goldberg RJ, et al. Delay to reperfusion in patients with acute myocardial infarction presenting to acute care hospitals: an international perspective. Eur Heart J. 2010 Jun;31(11):1328–36.
Spencer, Frederick A., et al. “Delay to reperfusion in patients with acute myocardial infarction presenting to acute care hospitals: an international perspective.Eur Heart J, vol. 31, no. 11, June 2010, pp. 1328–36. Pubmed, doi:10.1093/eurheartj/ehq057.
Spencer FA, Montalescot G, Fox KAA, Goodman SG, Granger CB, Goldberg RJ, Oliveira GBF, Anderson FA, Eagle KA, Fitzgerald G, Gore JM, Global Registry of Acute Coronary Events (GRACE) Investigators. Delay to reperfusion in patients with acute myocardial infarction presenting to acute care hospitals: an international perspective. Eur Heart J. 2010 Jun;31(11):1328–1336.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

June 2010

Volume

31

Issue

11

Start / End Page

1328 / 1336

Location

England

Related Subject Headings

  • Young Adult
  • Time Factors
  • Thrombolytic Therapy
  • Regression Analysis
  • Patient Transfer
  • Myocardial Reperfusion
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans