title: [Networks of care for ST-elevation myocardial infarction in Italy. Results of the RETE IMA WEB survey].
abstract: BACKGROUND
  The organization of a regional system of care (RSC) for ST-elevation myocardial infarction (STEMI) is recommended by the Italian Federation of Cardiology (FIC) and international guidelines in order to increase the number of patients treated with primary coronary angioplasty and, more in general, with reperfusion therapy, speed up the diagnostic and therapeutic processes, and ultimately improve the outcome.
  
  
  METHODS
  The "RETE IMA WEB" survey was launched in 2007 from the Italian Society of Invasive Cardiology (SICI-GISE) in collaboration with the FIC, with the aim of evaluating the current state of RSC for STEMI in Italy. The personnel of the 118 Emergency System participated in the survey. Data collection was made using different electronic forms with access limited by personal passwords. We assessed the organization of the RSC together with local resource availability, with specific attention to the distance from a Hub center.
  
  
  RESULTS
  The survey ended in December 31, 2008. We censored 701 hospitals admitting STEMI patients, 157 (22.4%) with uninterrupted access (h24/7 days) to the catheterization laboratory (2.67 per million inhabitants). An operative network was present in 36/103 (35.9%) provinces, with important geographic variability. Among hospitals without a full-time primary angioplasty facility, only 46% was within a RSC. ECG was available in 72% of the national territory, telemedicine in 50%. Prehospital fibrinolysis was available in 16% of the country. Overall, 92.4% of the Italian population resides within 60 min of a Hub center.
  
  
  CONCLUSIONS
  In 2008, despite an adequate framework, the RSC for STEMI in Italy was heterogeneous and still suboptimal. Healthcare administrators, scientific societies and all operators involved in the process of care for STEMI should make efforts to implement current guidelines.
authors: Istituto di Cardiologia, Universita degli Studi, Policlinico S. Orsola-Malpighi, Bologna. antonio.marzocchi@tin.it
authors: Antonio
authors: A
authors: Marzocchi
authors: Francesco
authors: F
authors: Saia
authors: Leonardo
authors: L
authors: Bolognese
authors: Corrado
authors: C
authors: Tamburino
authors: Arturo
authors: A
authors: Giordano
authors: Angelo
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authors: Ramondo
authors: Giuseppe Massimo
authors: GM
authors: Sangiorgi
authors: Fabrizio
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authors: Tomai
authors: Claudio
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authors: Cavallini
authors: Gennaro
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authors: Sardella
authors: Pietro
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authors: Cortesi
authors: Giuseppe
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authors: Di Pasquale
authors: Stefano
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authors: De Servi