Clinical Review: Management of Patients with Acute ST-Elevation Myocardial Infarction.

AIMS

The aim was to assess the quality of practice provided to acute ST-elevation myocardial infarction (STEMI) patients at the cardiac center, within a specified time frame and identify possible areas of improvement.

SETTINGS AND DESIGN

This is a retrospective standards-based clinical review, including adults diagnosed with acute STEMI between January 1, 2016 and January 1, 2017 of cases admitted and managed at the respective cardiac center.

SUBJECTS AND METHODS

The study was designed according to recommendations provided by the National Institute for Health and Care Excellence guidelines: "The acute management of myocardial infarction with ST-segment elevation;" alongside, the local standard: door-to-balloon time ≤90 min, adopted from the American Heart Association.

STATISTICAL ANALYSIS USED

Data analysis was done through excel and SPSS for advanced statistical calculations. < 0.05 was considered to be statically significant.

RESULTS

In total, 277 patients were included in the study. About 72% underwent primary percutaneous coronary intervention with 62 min as median door-to-balloon time. Door-to-balloon time >90 min was significantly higher when patients presented outside official hospital hours ( = 0.039). Transradial route was chosen in 77.7% of the cases.

CONCLUSIONS

Practice at the cardiac center was found to show good compliance with the guidelines. However, door-to-balloon time for procedures performed out of official hospital working hours was slightly outside the recommended limit.