On- vs off-hours primary percutaneous coronary intervention: a single-center 5-year experience

Area of Science:

• Cardiology
• Emergency Medicine
• Health Services Research

Background:

• Treatment delays in ST-segment elevation myocardial infarction (STEMI) significantly impact patient outcomes.
• The influence of admission timing on STEMI patient outcomes, particularly with percutaneous coronary intervention (PCI), remains unclear.

Purpose of the Study:

• To investigate the association between STEMI patient admission time and outcomes in a PCI center.
• To determine if admission during on-hours versus off-hours affects reperfusion delays and mortality.

Main Methods:

• Retrospective cohort study of 1222 STEMI patients treated with PCI.
• Defined on-hours as Monday-Friday, 8:00 AM-6:00 PM, excluding national holidays.
• Compared baseline characteristics, reperfusion times, in-hospital mortality, and 1-year mortality between on-hours and off-hours admissions.

Main Results:

• 36% of patients were admitted on-hours, 64% off-hours, with balanced baseline characteristics.
• No significant difference in median reperfusion time between on-hours (120 min) and off-hours (123 min) admissions.
• No association found between admission time and in-hospital (5% vs 5%) or 1-year mortality (10% vs 10%).

Conclusions:

• Admission timing to a PCI center was not associated with reperfusion delays in STEMI patients.
• The timing of STEMI patient admission did not correlate with increased in-hospital or 1-year mortality.
• Contemporary emergency networks appear to provide consistent STEMI care irrespective of admission scheduling.