CODE STEMI Program Improves Clinical Outcome in ST Elevation Myocardial Infarction Patients: A Retrospective Cohort
Eka Ginanjar1, Amal C Sjaaf2, Idrus Alwi1
1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Open Access Emergency Medicine : OAEM
|November 11, 2020
Summary
The CODE STEMI program significantly reduced door-to-balloon time for ST-elevation myocardial infarction (STEMI) patients. This initiative also showed a trend towards lower major adverse cardiac events and mortality rates.
Area of Science:
- Cardiology
- Emergency Medicine
- Healthcare Management
Background:
- ST-elevation myocardial infarction (STEMI) is a leading cause of cardiac mortality.
- Delays in STEMI patient management significantly increase mortality and morbidity risks.
- Effective protocols are crucial for improving outcomes in STEMI care.
Purpose of the Study:
- To evaluate the impact of the CODE STEMI program on major adverse cardiac events (MACE) and mortality in STEMI patients.
- To assess the effectiveness of a standardized STEMI response program at a major general hospital.
- To determine if the CODE STEMI program reduces critical time intervals in STEMI treatment.
Main Methods:
- Retrospective cohort study of 207 STEMI patients undergoing primary percutaneous coronary intervention (PPCI) between 2015 and 2018.
- Patients were divided into two groups: pre-CODE STEMI implementation and post-implementation (from January 2017).
- Analysis of in-hospital mortality, 30-day MACE, and door-to-balloon time (D2BT) using Mann-Whitney and chi-square tests.
Main Results:
- The CODE STEMI program significantly reduced mean door-to-balloon time by 130 minutes (288±306 min vs. 158±81 min, P<0.001).
- A trend towards lower in-hospital mortality was observed (8.3% vs. 4.4%, RR=0.53).
- A trend towards reduced 30-day MACE was also noted (48.61% vs. 37.78%, RR=0.77).
Conclusions:
- Implementation of the CODE STEMI program effectively reduces door-to-balloon time.
- The program demonstrates a potential to decrease MACE and mortality rates in STEMI patients.
- Standardized STEMI protocols are beneficial in general hospital settings.
Keywords:
CODE STEMImajor adverse cardiac eventmortalitymyocardial infarctionpercutaneous coronary interventionMore Related Videos
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