title: Temporal trends in prehospital management of ST-segment elevation myocardial infarction from 2002 to 2010 in Cote d'Or: data from the RICO registry (obseRvatoire des Infarctus de Cote d'Or).
abstract: BACKGROUND
  Myocardial infarction with ST-segment elevation (STEMI) is a medical emergency requiring specific management, with the main aim of achieving reperfusion as quickly as possible. Guidelines from medical societies have defined optimal management, with proven efficacy on morbi-mortality.
  
  
  OBJECTIVE
  Our study aimed to evaluate trends in practices between 2002 and 2010 in the emergency management of STEMI in a single French department, namely Cote d'Or.
  
  
  METHODS
  All patients admitted with a first STEMI to one of the six participating coronary care units (private or public) in Cote d'Or since January 2001 were included in a prospective registry (obseRvatoire des Infarctus de Côte d'Or [RICO]). Based on these data, we analysed trends in prehospital times between 2002 and 2010.
  
  
  RESULTS
  A total of 4114 patients were included in this analysis. Between 2002 and 2010, there was an increase in the proportion of patients who contacted the emergency services (by dialling 15) as first medical contact; however, the time from onset of symptoms to first medical contact remained stable over the study period. Overall, there was little change in prehospital management times but we noted a slight reduction in time to reperfusion.
  
  
  CONCLUSIONS
  Despite some improvement in prehospital management practices between 2002 and 2010 in Cote d'Or, there is still significant room for improvement to achieve earlier reperfusion in STEMI patients.
authors.affiliation: SAMU 21, Prehospital Care Department, Hôpital Général, University of Burgundy, Dijon, France.
authors.forename: Esther
authors.initials: E
authors.lastname: Milojevitch
authors.forename: Luc
authors.initials: L
authors.lastname: Lorgis
authors.forename: Nicolas
authors.initials: N
authors.lastname: Falvo
authors.forename: Philippe
authors.initials: P
authors.lastname: Buffet
authors.forename: Laurent
authors.initials: L
authors.lastname: Boidron
authors.forename: Gilles
authors.initials: G
authors.lastname: Dentan
authors.forename: Christophe
authors.initials: C
authors.lastname: Avena
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Beer
authors.forename: Karim
authors.initials: K
authors.lastname: Boudenia
authors.forename: Marianne
authors.initials: M
authors.lastname: Zeller
authors.forename: Marc
authors.initials: M
authors.lastname: Freysz
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
mesh_terms: D004632:Emergency Medical Services / Q000639:trends*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D013997:Time Factors