The effects of prearrival direct notification call to interventional cardiologist on door-to-balloon time in patients who required secondary diversion with ST-elevation myocardial infarction for primary percutaneous coronary intervention

摘要

Background: Rapid door-to-balloon times in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention are associated with favorable outcomes. Objectives: We evaluated the effects of prearrival direct notification calls to interventional cardiologists on door-to-balloon time for ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Methods: A 24-h hotline was created to allow prearrival direct notification calls to interventional cardiologists when transferring ST-elevation myocardial infarction patients. In an urban, tertiary referral center, patients who visited via inter-facility or the emergency department directly were included. Clinical parameters, time to reperfusion therapy, and in-hospital mortality were compared between patients with and without prearrival notifications. Results: Of 228 ST-elevation myocardial infarction patients, 95 (41.7%) were transferred with prearrival notifications. In these patients, door-to-balloon time was shorter (50.0 vs 60.0?min, p?=?0.010) and the proportion of patients with door-to-balloon time??90?min was higher (89.5% vs 75.9%, p?=?0.034) than patients without notifications. These improvements were more pronounced during “off-duty” hours (52.0 vs 78.0?min, p?=?0.001; 88.3% vs 72.3%, p?=?0.047, respectively) than during “on-duty” hours (37.5 vs 43.5?min, p?=?0.164; 94.4% vs 79.4%, p?=?0.274, respectively). In addition, door-to-activation time (–39 vs 11?min, p??0.001) and door-to-catheterization laboratory arrival time (33 vs 42?min, p?=?0.007) were shorter in patients with prearrival notifications than those without. However, in-hospital mortality was similar between the two groups (6.3% vs 6.8%, p?=?0.892). Conclusion: Prearrival direct notification calls to interventional cardiologists significantly improved the door-to-balloon time and the proportion of patients with door-to-balloon time ?90?min through rapid patient transport in primary percutaneous coronary intervention scheduled hospital and readiness of the catheterization laboratory.