title: The STAT-MI (ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction) trial improves outcomes.
abstract: OBJECTIVE
  The goal of this study was to evaluate the impact of the STAT-MI (ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction) network on outcomes in the treatment of patients presenting with ST-segment elevation myocardial infarction (STEMI).
  
  
  BACKGROUND
  Shortening door-to-balloon (D2B) time remains a national priority for the treatment of STEMI. We previously reported a fully automated wireless network (STAT-MI) for transmission of electrocardiograms (ECGs) for suspected STEMI from the field to offsite cardiologists, allowing early triage with shortening of subsequent D2B times. We now report the impact of the STAT-MI wireless network on infarct size, length of hospital stay (LOS), and mortality.
  
  
  METHODS
  A fully automated wireless network (STAT-MI) was developed to enable automatic 12-lead ECG transmission and direct communication between emergency medical services personnel and offsite cardiologists that facilitated direct triage of patients to the cardiac catheterization laboratory. Demographic, laboratory, and time interval data of STAT-MI network patients were prospectively collected over a 33-month period and compared with concurrent control patients who presented with STEMI through non-STAT-MI pathways.
  
  
  RESULTS
  From June 2006 through February 2009, 92 patients presented via the STAT-MI network, and 50 patients presented through non-STAT-MI pathways (control group). Baseline clinical and demographic variables were similar in both groups. Overall, compared with control subjects, STAT-MI patients had significantly shorter D2B times (63 [42 to 87] min vs. 119 [96 to 178] min, U = 779.5, p < 0.00004), significantly lower peak troponin I (39.5 [11 to 120.5] ng/ml vs. 87.6 [38.4 to 227] ng/ml, U = 889.5, p = 0.005) and creatine phosphokinase-MB (126.1 [37.2 to 280.5] ng/ml vs. 290.3 [102.4 to 484] ng/ml, U = 883, p = 0.001), higher left ventricular ejection fractions (50% [35 to 55] vs. 35% [25 to 52], U = 1,075, p = 0.004), and shorter LOS (3 [2 to 4] days vs. 5.5 [3.5 to 10.5] days, U = 378, p < 0.001).
  
  
  CONCLUSIONS
  A fully automated, field-based, wireless network that transmits ECGs automatically to offsite cardiologists for the early evaluation and triage of patients with STEMI shortens D2B times, reduces infarct size, limits ejection fraction reduction, and shortens LOS.
authors.affiliation: Department of Medicine, Division of Cardiology, University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, New Jersey 07103, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Sanchez-Ross
authors.forename: Gerard
authors.initials: G
authors.lastname: Oghlakian
authors.forename: James
authors.initials: J
authors.lastname: Maher
authors.forename: Brijesh
authors.initials: B
authors.lastname: Patel
authors.forename: Victor
authors.initials: V
authors.lastname: Mazza
authors.forename: David
authors.initials: D
authors.lastname: Hom
authors.forename: Vivek
authors.initials: V
authors.lastname: Dhruva
authors.forename: David
authors.initials: D
authors.lastname: Langley
authors.forename: Jack
authors.initials: J
authors.lastname: Palmaro
authors.forename: Sultan
authors.initials: S
authors.lastname: Ahmed
authors.forename: Edo
authors.initials: E
authors.lastname: Kaluski
authors.forename: Marc
authors.initials: M
authors.lastname: Klapholz
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D016507:Cardiology Service, Hospital / Q000458:organization & administration; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000458:organization & administration; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D009515:New Jersey; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011446:Prospective Studies; D011787:Quality of Health Care; D013318:Stroke Volume; D017216:Telemedicine / Q000458:organization & administration; D013997:Time Factors; D016896:Treatment Outcome; D014218:Triage; D019210:Troponin I / Q000097:blood; D016277:Ventricular Function, Left; D059015:Wireless Technology / Q000458:organization & administration
chemical_list: D015415:Biomarkers; D019210:Troponin I; D052279:Creatine Kinase, MB Form