Comparison of official hours versus non-official hours: percutaneous coronary intervention in acute ST-elevation

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Suphot Srimahachota1, Smonporn Boonyaratavej, Wasan Udayachalerm

  • 1Cardiac center and Division of Cardiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. trcssmc@md2.md.chula.ac.th

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|July 12, 2007
PubMed

Insights

This study found that while percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) had longer door-to-balloon times during non-official hours (non-OH), overall treatment delays and in-hospital mortality rates were similar compared to official hours (OH).

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Public Health

Background:

  • Percutaneous coronary intervention (PCI) is a primary treatment for acute ST-elevation myocardial infarction (STEMI).
  • Treatment delays during non-official hours (non-OH) may negatively impact PCI outcomes in STEMI patients.

Purpose of the Study:

  • To compare the clinical outcomes of PCI in acute STEMI patients treated during official hours (OH) versus non-OH.
  • To analyze the impact of treatment timing on in-hospital mortality following PCI for STEMI.

Main Methods:

  • A prospective registry analysis of 256 acute STEMI patients undergoing PCI from May 1999 to December 2003.
  • Comparison of patient demographics, clinical characteristics, and procedural outcomes between OH and non-OH groups.
  • Kaplan Meier survival analysis and multivariate analysis were used to assess in-hospital mortality.

Main Results:

  • Patient demographics and clinical severity were similar between OH and non-OH groups.
  • Door-to-balloon and decision-to-balloon times were significantly shorter in the OH group (p < 0.001).
  • Despite longer initial times, total delayed time was not significantly different (p = 0.55), and in-hospital mortality rates were comparable (10.3% vs. 10.7%).

Conclusions:

  • While PCI procedural times are longer during non-OH, overall treatment delays and in-hospital mortality for STEMI patients remain similar.
  • This suggests that established protocols may mitigate the impact of off-hours treatment timing on critical outcomes.
Abstract

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