Interhospital transfer of patients with ST-segment elevation myocardial infarction for percutaneous coronary intervention

Fausan S. Tsai, William M. Mellana, Wilbert S. Aronow, Chul Ahn, Ambra Ferraris, Majid Dudha, Kumar Kalapatapu, Anthony L. Pucillo, Craig E. Monsen

Research output: Contribution to journalArticlepeer-review

Abstract

We investigated in 277 consecutive patients, mean age 63 years, with ST-segment elevation acute myocardial infarction transferred from 25 community hospitals to a tertiary percutaneous coronary intervention (PCI) center from a median distance of 21 miles the incidences of in-hospital mortality, stroke, and recurrent myocardial infarction associated with transfer times. Of the 277 patients, 158 (57%) had thrombolytic therapy at the referring hospital. Of the 277 patients, 63 (23%) had adjunctive PCI, 119 (43%) had primary PCI, and 95 (34%) had rescue PCI. Of the 277 patients, 42 (15%) were hemodynamically unstable. Median transfer times were 102 minutes with primary PCI, 119 minutes with rescue PCI, and 144 minutes for adjunctive PCI (P < 0.0001 for adjunctive PCI versus primary PCI; P = 0.011 for adjunctive PCI versus rescue PCI). Median transfer time was 98 minutes for hemodynamically unstable patients and 121 minutes for hemodynamically stable patients (P = 0.005). In-hospital death occurred in eight of 277 patients (3%). In-hospital stroke occurred in three of 277 patients (1%). In-hospital recurrent myocardial infarction occurred in none of 277 patients (0%). There was no association of transfer times with in-hospital mortality or stroke. In-hospital mortality occurred in three of 112 patients (3%) who had bare metal stents and in five of 165 patients (3%) who had drug-eluting stents.

Original languageEnglish (US)
Pages (from-to)e189-e192
JournalAmerican Journal of Therapeutics
Volume17
Issue number6
DOIs
StatePublished - Nov 1 2010

Keywords

  • acute myocardial infarction
  • bare metal stents
  • cardiac troponins
  • drug-eluting stents
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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