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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Clinical Efficacy of Pre-Hospital Electrocardiogram Transmission in Patients Undergoing Primary Percutaneous Coronary

Keiichi Kohashi1, Masataka Nakano1, Takaaki Isshiki1

  • 1Department of Cardiology, Ageo Central General Hospital.

International Heart Journal
|July 17, 2023
PubMed

Insights

Pre-hospital electrocardiogram (PH-ECG) transmission by emergency medical services (EMS) significantly reduces door-to-balloon time and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI).

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • Primary percutaneous coronary intervention (pPCI) is a key treatment for ST-segment elevation myocardial infarction (STEMI).
  • Pre-hospital electrocardiogram (PH-ECG) transmission by emergency medical services (EMS) can expedite reperfusion therapy.
  • Limited data exist on the specific clinical benefits of PH-ECG at individual hospital levels.

Purpose of the Study:

  • To investigate the clinical efficacy of PH-ECG transmission in STEMI patients undergoing pPCI.
  • To evaluate the impact of PH-ECG on door-to-balloon time (D2BT) and patient mortality.
  • To assess the role of EMS-provided PH-ECG information in STEMI management.

Main Methods:

  • Retrospective, observational study of 237 STEMI patients undergoing pPCI.
  • Patients divided into two groups: PH-ECG transmission group (n=77) and non-PH-ECG group (n=160).
  • Comparison of D2BT, 30-day all-cause mortality, and outcomes stratified by GRACE score.

Main Results:

  • The PH-ECG group had a significantly shorter D2BT (66 min vs. 70 min, P=0.01).
  • 30-day all-cause mortality was significantly lower in the PH-ECG group (6% vs. 16%, P=0.037).
  • The survival benefit was more pronounced in severely ill patients (stratified by GRACE score).

Conclusions:

  • PH-ECG transmission by EMS improves survival rates for STEMI patients undergoing pPCI.
  • Enhanced pre-arrival preparation through EMS information is crucial for STEMI care.
  • Effective coordination between EMS and PCI-capable hospitals is essential for managing PH-ECG.

Keywords:
Door-to-balloon timeEarly reperfusion therapy

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