Total ischaemic time in STEMI: factors influencing systemic delay
Cormac T O'Connor1, Abdallah Ibrahim2, Anthony Buckley1
1Interventional Fellow Department of Cardiology, University Hospital Limerick, Limerick, Ireland.
The British Journal of Cardiology
|October 10, 2022
Summary
Patient delay significantly prolongs total ischaemic time in ST-elevation myocardial infarction (STEMI). Improving public and healthcare awareness is crucial for reducing delays in primary percutaneous coronary intervention (pPCI) and improving outcomes.
Area of Science:
- Cardiology
- Public Health
Background:
- Total ischaemic time is a critical predictor of mortality in ST-elevation myocardial infarction (STEMI).
- Timely reperfusion therapy, such as primary percutaneous coronary intervention (pPCI), is essential for improving outcomes in STEMI patients.
Purpose of the Study:
- To assess the total ischaemic time in STEMI patients undergoing pPCI at an Irish centre.
- To identify factors contributing to delays in STEMI treatment.
Main Methods:
- A prospective observational study of 213 STEMI patients referred for pPCI between October 2017 and January 2019.
- Analysis of ischaemic time, patient delay (time to call for help), and system delays (e.g., ECG-to-wire cross time).
Main Results:
- Mean ischaemic time was 387 minutes, with patient delay (207 minutes) constituting the majority.
- Increasing age correlated with longer patient delay.
- Women experienced longer ischaemic times than men, primarily due to delays between first medical contact (FMC) and ECG acquisition.
Conclusions:
- Patient delay is the primary contributor to prolonged ischaemic time in STEMI.
- Targeted public awareness campaigns and enhanced healthcare protocols are needed to reduce delays.
- Addressing gender-specific delays in care, particularly from FMC to ECG, is important.
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