[Reperfusion delays in acute coronary syndromes with ST segment elevation (STEMI) depending on prehospital care].
BACKGROUND
Acute coronary syndrome with ST segment elevation (STEMI) remains a major cause of morbidity and mortality in France, directly correlated with the time management of the patient to achieve reperfusion of the artery as early as possible. But the delay of reperfusion is related to the course that will take the patient to the revascularization.


METHODS
To make an observation of departmental practices, we conducted a retrospective monocentric study on the STEMI supported on 4years in the Departmental Hospital of La Roche-sur-Yon by comparing the time of reperfusion in two groups: patients who used the recommended chain=diRect chain (Call the emergency number-specialist mobile emergency unit-Cardiac intensive care unit or cardiac catheterization laboratory), and patients who used another chain=Long chain.


RESULTS
On 838 patients with STEMI, 356 (42.5%) used the Direct chain. The average time of reperfusion in the Direct chain group is 4.26hours (±3.12), 6.17hours (±4.82) in the Long chain group. There is a significant difference between the two groups of 1.9hours (P<0.001). Of 186 patients who consulted a general practitioner, 40.3% of patients were not supported by the mobile emergency unit.


CONCLUSIONS
These results should lead to improved practices, to carry on continuing medical education with all actors in the chain and patient information to shorten up the time of reperfusion.
Centre hospitalier départementale Vendée, Les Oudairies, 85925 La Roche-sur-Yon cedex 9, France.
M
M
Loirat
L
L
Orion
P
P
Fradin
J
J
Dimet
E
E
Boiffard
D054058:Acute Coronary Syndrome / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D061665:Time-to-Treatment
Chain; Fast-MI; Filière; Registres; Registries; Reperfusion; Revascularization; ST elevation myocardial infarction; Stent for Life; Syndrome coronarien aigu ST+; Vendée