Mané Fernando, Flores Rui, Silva Rodrigo, Conde Inês, Ferreira Ana Sofia, Costa João, Quina-Rodrigues Catarina, Galvão-Braga Carlos, Marques Jorge
Cardiologia, Hospital de Braga, Braga, Portugal Cardiologia Hospital de Braga Braga Portugal.
Medicina Interna, Unidade de Saúde Local do Alto Minho, Hospital de Santa Luzia, Viana do Castelo, Portugal Medicina Interna Unidade de Saúde Local do Alto Minho Hospital de Santa Luzia Viana do Castelo Portugal.
REC Interv Cardiol. 2024 Mar 4;6(2):76-82. doi: 10.24875/RECIC.M23000429. eCollection 2024 Apr-Jun.
In patients with ST-segment elevation myocardial infarction (STEMI) treatment delay significantly affects outcomes. The effect of admission time in STEMI patients is unknown when percutaneous coronary intervention (PCI) is the preferred reperfusion strategy. This study aimed to determine the association between STEMI outcomes and the timing of admission in a PCI center in south-western Europe.
This retrospective cohort study analyzed the local electronic data from 1222 consecutive STEMI patients treated with PCI. On-hours were defined as admission from Monday to Friday between 8:00 AM and 6:00 PM on non-national holidays.
A total of 439 patients (36%) were admitted on-hours and 783 patients (64%) were admitted off-hours. Baseline characteristics were well-balanced between the 2 groups, including the percentage of patients admitted in cardiogenic shock (on-hours 5% vs off-hours 4%; = .62). The median time from first medical contact to reperfusion did not differ between the 2 groups (on-hours 120 minutes vs off-hours 123 minutes, = .54) and no association was observed between admission time and in-hospital mortality (on-hours 5% vs off-hours 5%, = .90) or 1-year mortality (on-hours 10% vs off-hours 10%, = .97). Survival analysis showed no differences in on-hours PCI vs off-hours PCI (HR, 1.1; 95%CI, 0.74-1.64; = .64).
In a contemporary emergency network, the timing of STEMI patients' admission to the PCI center was not associated with reperfusion delays or increased mortality.
在ST段抬高型心肌梗死（STEMI）患者中，治疗延迟会显著影响预后。当经皮冠状动脉介入治疗（PCI）是首选的再灌注策略时，STEMI患者的入院时间对预后的影响尚不清楚。本研究旨在确定欧洲西南部一家PCI中心STEMI患者的预后与入院时间之间的关联。
这项回顾性队列研究分析了1222例接受PCI治疗的连续性STEMI患者的本地电子数据。工作时间定义为周一至周五非国定假日的上午8:00至下午6:00入院。
共有439例患者（36%）在工作时间入院，783例患者（64%）在非工作时间入院。两组之间的基线特征均衡，包括心源性休克患者的入院百分比（工作时间5% vs非工作时间4%；P = 0.62）。两组之间从首次医疗接触到再灌注的中位时间无差异（工作时间120分钟vs非工作时间123分钟，P = 0.54），且未观察到入院时间与院内死亡率（工作时间5% vs非工作时间5%，P = 0.90）或1年死亡率（工作时间10% vs非工作时间10%，P = 0.97）之间存在关联。生存分析显示工作时间PCI与非工作时间PCI之间无差异（HR，1.1；95%CI，0.74 - 1.64；P = 0.64）。
在当代急诊网络中，STEMI患者入住PCI中心的时间与再灌注延迟或死亡率增加无关。
