Time to Treatment Delay and Clinical Indicators in Patients with ST-Segment Elevation Myocardial Infarction: A
Mahsa Motadayen1, Hossein Feizollahzadeh1, Mohamad Reza Taban2
1Department of Medical-Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
Insights
Delays in pre-primary percutaneous coronary intervention (PPCI) significantly extend treatment times for ST-segment elevation myocardial infarction (STEMI) patients. Improving logistics and education for STEMI management is crucial for timely care.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- ST-segment elevation myocardial infarction (STEMI) remains a critical global health concern.
- Effective management of STEMI requires continuous quality monitoring and process improvement.
- Primary percutaneous coronary intervention (PPCI) is a key treatment modality for STEMI.
Purpose of the Study:
- To investigate time delays in STEMI treatment.
- To identify clinical indicators associated with treatment delays in STEMI patients undergoing PPCI.
- To analyze factors contributing to pre-PPCI center delay and overall treatment delay.
Main Methods:
- A descriptive cross-sectional study involving 313 STEMI patients treated with PPCI.
- Data collected in Tabriz, Iran, in 2023.
- Statistical analysis included descriptive statistics, Mann-Whitney U, Kruskal-Wallis, chi-square tests, and regression analysis.
Main Results:
- The median door-to-balloon time was 80 minutes.
- Pre-PPCI center delay was 191 minutes; treatment delay was 310 minutes.
- Patient residence, admission type, left ventricular ejection fraction, troponin I levels, angioplasty outcome, and ACS drug administration were associated with delays.
Conclusions:
- Longer pre-PPCI center delay directly correlates with increased total treatment delay.
- Recommendations include optimizing logistics for STEMI patients and enhancing education for all stakeholders involved in STEMI management.
Introduction:
ST-segment elevation myocardial infarction (STEMI) continues to be a significant global health issue, necessitating ongoing monitoring of care processes to enhance quality. This study aimed to examine time to treatment delay and clinical indicators in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).
Methods:
This descriptive cross-sectional study was conducted with the recruitment of 313 patients with STEMI treated with PPCI Tabriz (Iran) in 2023. Data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, the chi-square test, and regression analysis in SPSS v.13 software.
Results:
Most of the patients were men and half of them were 60 years old or younger. The median door-to-balloon time [IQR] was 80 [49-140] minutes. The pre-PCI center delay time and treatment delay time were 191 and 310 minutes, respectively. There was a statistically significant association between the patient's place of residence, the admission type in the PCI center, and the pre-PCI center delay time. In addition, there was a statistically significant association between treatment delay time, left ventricular ejection fraction (LVEF), baseline troponin I level, angioplasty outcome, and receiving acute coronary syndrome (ACS) drugs at the pre-PCI center.
Conclusion:
The longer pre-PCI center delay time resulted in a longer total treatment delay. To reduce delays, it is proposed to improve the logistics surrounding these procedures for patients with STEMI and to provide appropriate education about the STEMI management program to all stockholders.
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