Time to and Use of Reperfusion Therapy in a Health Care Network

Javier Mariani, Maximiliano De Abreu, Carlos Tajer

Abstract


Background

Time delays to reperfusion therapy in the acute phase of myocardial infarction areassociated with lower treatment efficacy. Shortening these delays requires recognizingthe specific time components in each system of care.ObjectivesThe aim of this study was to analyze the use of reperfusion therapy and the timecomponents of its implementation in a network of public hospitals.MethodsPatients with acute coronary syndromes admitted to the coronary care unit of theHospital El Cruce were included in an observational, prospective study. Patientswith acute myocardial infarction were included for the description of time intervals.ResultsDuring the study period, 327 patients with acute myocardial infarction were hospitalized.Reperfusion therapy was administered to 63.6% of patients (65.9% weretreated with fibrinolytics and 34.1% underwent primary percutaneous intervention).Time to consultation was 60 minutes (interquartile range: 30 to 180 minutes).Door-to-needle time was 75 minutes (45 to 121 minutes). The time from the firstelectrocardiogram to balloon inflation in patients transferred for primary percutaneouscoronary intervention was 240 minutes (154 to 390 minutes) and was longer inpatients transferred from hospitals outside the network (p < 0.016).ConclusionsThe use of reperfusion therapy is suboptimal, with prolonged time delays in thehealth care system. Both aspects have been considered in a network-based myocardialinfarction care protocol and this study constitutes a baseline for the evaluationof future results.


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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar