title: Impact on delay times and characteristics of patients undergoing primary percutaneous coronary intervention in the southern metropolitan area of Barcelona after implementation of the infarction code program.
abstract: OBJECTIVE
  A standardized protocol of emergent transfer for primary percutaneous coronary intervention for patients with ST elevation myocardial infarction, defined as the Infarction Code, was implemented in June 2009 in the Catalan regional health system. The objective of this study was to evaluate the impact of the new protocol on delay times, number of procedures and clinical characteristics compared with the previous period in the population of patients referred to our hospital.
  
  
  METHODS
  All consecutive patients undergoing primary percutaneous coronary intervention in our hospital were prospectively registered. The clinical characteristics, delay times and mortality in the follow-up of the protocol implementation period (June 2009-May 2010) were analyzed and compared with the previous year (June 2008-May 2009).
  
  
  RESULTS
  During the protocol period, 514 patients were included, compared with 241 in the previous year. Age, cardiovascular risk factors, anterior myocardial infarction and procedure characteristics were similar in the 2 groups. The first medical contact to balloon time was lower in the protocol period (median time 120 min vs 88 min; P<.001). Patients in the protocol period showed a trend toward less severe disease (Killip III, rescue angioplasty). The multivariate regression analysis showed a significant association between 1-year mortality and age, Killip class ≥ III at admission, anterior infarction and 3-vessel disease.
  
  
  CONCLUSIONS
  The introduction of the Infarction Code program increased the number of patients treated by primary percutaneous coronary intervention with a reduction in delay times and better clinical characteristics at presentation. Full English text available from:www.revespcardiol.org.
authors.affiliation: Unidad de Hemodinámica y Cardiología Intervencionista, Área de Enfermedades del Corazón, Hospital Universitario de Bellvitge, IDIBELL, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España. 26587jgh@comb.cat
authors.forename: Joan Antoni
authors.initials: JA
authors.lastname: Gómez-Hospital
authors.forename: Paolo Domenico
authors.initials: PD
authors.lastname: Dallaglio
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Sánchez-Salado
authors.forename: Albert
authors.initials: A
authors.lastname: Ariza
authors.forename: Silvia
authors.initials: S
authors.lastname: Homs
authors.forename: Victoria
authors.initials: V
authors.lastname: Lorente
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Ferreiro
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.forename: Rafael
authors.initials: R
authors.lastname: Romaguera
authors.forename: Joel
authors.initials: J
authors.lastname: Salazar-Mendiguchía
authors.forename: Luis
authors.initials: L
authors.lastname: Teruel
authors.forename: Ángel
authors.initials: Á
authors.lastname: Cequier
mesh_terms: D000367:Age Factors; D000368:Aged; D059019:Clinical Coding; D003331:Coronary Vessels / Q000473:pathology; D016208:Databases, Factual; D057210:Delayed Diagnosis; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology