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.
Insights
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.
Purpose:
One of the most frequent causes of cardiac mortality is ST elevation myocardial infarction (STEMI). Delay in the management of STEMI patients is a cause of high mortality and morbidity. This study aims to determine the effect of the implementation of the CODE STEMI program on major adverse cardiac events (MACE) and mortality of STEMI patients at Dr. Cipto Mangunkusumo General Hospital.
Patients And Methods:
This was a retrospective cohort study that enrolled 207 STEMI patients who underwent primary percutaneous coronary intervention (PPCI) in 2015-2018. The patients were divided into two groups. The first group was treated prior to establishing the CODE STEMI program. The other group was treated according to the program, which was implemented in January 2017. Data were collected from medical records, and we retrospectively analyzed all in-hours, MACE, and mortality of STEMI patients from both groups as primary outcomes. Data analysis was done using the Mann-Whitney and chi-square test.
Results:
There were 72 and 135 patients in the pre-CODE STEMI and CODE STEMI groups, respectively. D2BT was significantly reduced by 130 min (288±306 vs 158±81, P< 0.001) since the implementation of CODE STEMI program. There were trends to lower in-hospital mortality rates (8.3% vs 4.4%, RR = 0.53) and MACE at 30 days (48.61% vs 37.78%, RR = 0.77).
Conclusion:
Implementation of the CODE STEMI program can reduce door-to-balloon time and decrease the MACE and mortality rate in STEMI patients in general hospitals.
More Related Videos
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:26Acute Coronary Syndrome V: Nursing Management