title: Primary percutaneous coronary intervention during on- vs off-hours in patients with ST-elevation myocardial infarction. Results from EUROTRANSFER Registry.
abstract: BACKGROUND
  Primary percutaneous coronary intervention (PPCI) is regarded as the treatment of choice for ST elevation myocardial infarction (STEMI) patients. It has been emphasised that only experienced centres with round-the-clock cathlab facilities should perform PPCI. Some investigators have doubted whether PPCI performed during 'off-hours' is as effective and safe as that performed during regular hours. Papers supporting both possibilities have been published.
  
  
  OBJECTIVE
  To investigate whether off-hours PPCI is associated with impaired immediate and long-term outcomes based on a contemporary European registry study.
  
  
  METHODS
  Consecutive data on STEMI patients referred for PPCI in hospital STEMI networks between November 2005 and January 2007 was gathered. Patients were divided into two groups: PPCI performed during 'on-hours' and PPCI performed during 'off-hours (including Saturdays and Sundays)'.
  
  
  RESULTS
  Data from a total of 1,650 patients were collected in the EUROTRANSFER Registry. There were 1,005 patients in the off-hours group (61%) and 645 (39%) patients in the on-hours group. Patients in both groups did not differ in baseline demographics. Thrombolysis before admission to cathlab was more frequently administered to patients off-hours (4.1% vs 2.3%, p = 0.041). The PPCI complications were rare and occurred in similar frequency in the studied groups. Time from chest pain onset to diagnosis of STEMI was shorter in the off-hours group (173 ± 210 vs 183 ± 187, p = 0.007). In-hospital mortality was 3.4% in the on-hours group and 4.3% in the off-hours group (NS).
  
  
  CONCLUSIONS
  The PPCI performed in high-volume, experienced invasive cardiology centres in Europe during off-hours is associated with a comparable outcome and safety profile as PPCI performed during regular working hours.
authors: 2nd Department of Cardiology, University Hospital, Krakow, Poland.
authors: Zbigniew
authors: Z
authors: Siudak
authors: Tomasz
authors: T
authors: Rakowski
authors: Artur
authors: A
authors: Dziewierz
authors: Jacek
authors: J
authors: Skowronek
authors: Joanna
authors: J
authors: Rutka
authors: Maciej
authors: M
authors: Bagieński
authors: Paweł
authors: P
authors: Ranosz
authors: Jacek S
authors: JS
authors: Dubiel
authors: Dariusz
authors: D
authors: Dudek
mesh_terms: D039602:After-Hours Care; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D002983:Clinical Competence / Q000592:standards*; D005060:Europe; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D012042:Registries; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors