[Primary Coronary Intervention (PCI) within the myocardial infarction network system in a German city (Essen)].
In a German city (Essen, 490,000 people), a new network system for patients with ST elevation myocardial infarction (STEMI) was established in 2004. This included a so-called integrated care model (IV model) by participation of insurance companies. In a cooperative structure between invasive and noninvasive hospitals, general practitioners and cardiologists as well as emergency systems it could be realized, that every patient with STEMI will be treated by primary percutaneous coronary intervention (PCI) as soon as possible according to the current guidelines. The patient characteristics (age, gender, comorbidity, medication) were comparable to other trials and registries. The primary success rate was high (96.4%). The acute in-hospital results demonstrated a low mortality (7.6%). The time periods of delay were comparable to other registries. The symptom-to-balloon time was 239 min, the medical contact-to-balloon time 95 min, the door-to-balloon time 60 min, and the puncture-to-balloon time 18 min (median values). The STEMI network system in Essen demonstrates the possibility of modern therapy in patients with myocardial infarction (primary PCI) in a cooperative modality between all participants in the health-care system.
Jacksch
Rainer
R
Katholische Kliniken Essen Nord-West gGmbH, St. Vincenz-Krankenhaus, Essen. r.jacksch@kkenw.de
Naber
Christoph K
CK
Koslowski
Bernd
B
Budde
Thomas
T
Hailer
Birgit
B
Sabin
Georg
G
Haude
Michael
M
Wald
Christof
C
Erbel
Raimund
R
D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D017023:Coronary Angiography; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D004632:Emergency Medical Services / Q000458:organization & administration*; D005858:Germany; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D012042:Registries; D015996:Survival Rate; D013996:Time and Motion Studies; D014504:Urban Health
D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex