title: Reduction in door-to-needle time to meet clinical guideline recommendations. Outcomes after 1 year.
abstract: The aim of this study was to reduce the door-to-needle time in patients with ST-elevation acute myocardial infarction by setting up a chest pain service. We compared the door-to-needle time and outcomes at the end of first year of follow-up in patients who received fibrinolysis in the 2 years before implementation of the service (Group 1) and those who received fibrinolysis in the 2 years after its creation (Group 2). In Group 1, the median door-to-needle time was 40 min (P(25-75), 23-52 min); in Group 2, it was 27 min (P(25-75), 15-43 min; P=.003). In addition, the use of reperfusion therapy increased from 55.2% in Group 1 to 64.7% in Group 2 (P< .01). After a follow-up period of 1 year, there was no difference in the rate of revascularization, hospital readmission, reinfarction or cardiovascular mortality.
authors.affiliation: Servicio de Cardiología, Hospital del Mar, Barcelona, Spain. CGarciaG@imas.imim.es
authors.forename: Cosme
authors.initials: C
authors.lastname: García-García
authors.forename: Lluís
authors.initials: L
authors.lastname: Recasens
authors.forename: Nuria
authors.initials: N
authors.lastname: Casanovas
authors.forename: Faustino
authors.initials: F
authors.lastname: Miranda
authors.forename: Francisco
authors.initials: F
authors.lastname: del Baño
authors.forename: Josep M
authors.initials: JM
authors.lastname: Manresa
authors.forename: Antoni
authors.initials: A
authors.lastname: Serra
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruguera
mesh_terms: D002985:Clinical Protocols; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D015912:Thrombolytic Therapy; D013997:Time Factors