• Jaime Aboal, Rafel Ramos, Pablo Loma-Osorio, Maria Núñez, Marc Comas-Cufi, Josep Iglesies, Sergio Moral, Daniel Bosch, Ruth Martí-Lluch, Lia Alves-Cabratosa, and Ramon Brugada.
• Hospital Universitario Josep Trueta, Girona, España.
• Emergencias. 2021 Jun 1; 33 (3): 195-202.

ObjectivesTo identify predictors of primary angioplasty delay in patients with ST-elevation myocardial infarction (STEMI) transported from out-of-hospital sites or from hospitals without percutaneous coronary intervention (PCI) suites.Material And MethodsRetrospective cohort study of cases between 2008 and 2018 in a university hospital receiving patients diagnosed with STEMI who required a PCI. We performed linear and multivariate regression analyses to identify factors that predicted delay in interpreting a diagnostic electrocardiogram (ECG) until the guidewire passed the lesion (diagnosis-guidewire-crossing time).ResultsA total of 1039 cases were studied; 296 patients (28.4%) had delays of more than 120 minutes between STEMI diagnosis and guidewire crossing. Factors associated with PCI delay were advanced age (odds ratio [OR] = 1.02; 95% CI, 1.01-1.04]), severe heart failure on admission (OR = 2.28; 95% CI, 1.23-4.22), history of cardiac bypass surgery (OR = 10.01; 95% CI, 2.60-41.81), out-of-hospital cardiac arrest (OR = 4.34; 95% CI, 1.84-10.32), lateral ischemia (OR, 1.64; 95% CI, 1.06-2.51), first medical attention in a hospital without a PCI suite (OR = 1.52; 95% CI, 1.05-2.21), first medical attention outside regular working hours (OR = 1.46; 95% CI, 1.06-2.02), and distance in kilometers to a PCI suite (OR = 1.04; 95% CI, 1.03-1.05).ConclusionPatients with STEMI who required transport to a hospital with a PCI suite experienced primary angioplasty delays. Delays were related to logistical and clinical factors as well as to infarction characteristics.

18 keywords...

hide…