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Related Concept Videos

Pulse rhythm01:30

Pulse rhythm

768
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
768
Parentral Nutrition: Centeral and Peripheral Parental Nutrition01:27

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

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Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
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Updated: Jun 6, 2025

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Primary Percutaneous Coronary Intervention during Off-Hours: One-Decade Experience from a High-Volume Cardiovascular

Filipe Cirne1,2, Marcia Moura Schmidt1, Cristiano Oliveira Cardoso3

  • 1Instituto de Cardiologia - Programa de Pós-Graduação em Ciências da Saúde, Porto Alegre, RS - Brasil.

Arquivos Brasileiros De Cardiologia
|November 28, 2024
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Summary

Primary percutaneous coronary intervention (pPCI) performed off-hours in STEMI patients showed similar procedural success but higher major adverse cardiovascular events (MACE) and mortality rates. These findings highlight potential risks associated with off-hours cardiac interventions.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Public Health

Background:

  • The clinical outcomes of primary percutaneous coronary intervention (pPCI) performed during off-hours (nights, weekends, holidays) remain incompletely understood.
  • Evaluating off-hours pPCI is crucial for optimizing patient care and resource allocation in cardiology centers.

Purpose of the Study:

  • To compare the baseline characteristics and 1-year major adverse cardiovascular events (MACE) of ST-elevation myocardial infarction (STEMI) patients undergoing pPCI during off-hours versus on-hours.
  • To assess the impact of timing on pPCI procedural success and patient outcomes in a high-volume center.

Main Methods:

  • A prospective cohort study included 2,560 patients treated with pPCI off-hours and 1,876 treated on-hours between 2009 and 2019.
  • Off-hours were defined as weekdays from 8 PM to 7:59 AM, plus weekends and holidays.
  • Baseline characteristics, procedural success, and 1-year MACE were compared between the on-hours and off-hours groups.

Main Results:

  • Patients treated off-hours had a higher thrombus burden and more frequent radial access utilization.
  • Procedural success rates were similar between off-hours (95.7%) and on-hours (96.4%) groups (p = 0.21).
  • Off-hours treatment was associated with significantly higher 30-day (10.2% vs. 8.5%; p = 0.04) and 1-year MACE (15.4% vs. 13.1%; p = 0.03), primarily driven by increased mortality rates.

Conclusions:

  • Despite similar clinical characteristics, door-to-balloon times, and procedural success rates, off-hours pPCI for STEMI is linked to worse clinical outcomes.
  • Patients undergoing off-hours pPCI experienced higher rates of MACE and mortality compared to those treated on-hours.
  • Further investigation is warranted to understand and mitigate the increased risks associated with off-hours STEMI interventions.