title: [Impacts of establishment of chest pain center on the door-to-balloon time and the short-term outcome after primary percutaneous coronary intervention of patients with ST segment elevated myocardial infarction].
abstract: OBJECTIVE
  To investigate the impact of the establishment of chest pain center (CPC) model based on the pre-hospital real-time tele-12-lead electrocardiogram on the door-to-balloon (D-to-B) time and short-term outcome after primary percutaneous coronary intervention (PPCI) of patients with ST-segment elevated myocardial infarction (STEMI).
  
  
  METHODS
  A regular CPC was established with pre-hospital transmitted real-time 12-lead electrocardiogram system for pre-hospital diagnosis of STEMI and enabled the STEMI patients to bypass the emergency room and directly treated in the catheter lab to shorten the D-to-B time. The mean D-to-B time, the short-term outcome and medical costs were compared in PPCI patients before (93 cases, group A) and after (149 cases, group B) the establishment of CPC.
  
  
  RESULTS
  After the establishment of CPC, the annual mean D-to-B time was significantly shortened [(127 ± 79) min in group A vs.(72 ± 23 )min in group B, P < 0.01], the shortest monthly mean D-to-B time was remarkably reduced in group B than in group A [(56 ± 11) min vs. (73 ± 14) min, P < 0.01]. The annual ratio of D-to-B below 90 minutes was significantly increased from 62.4% (58/93) in group A to 91.9% (137/149) in group B (P < 0.05) . The in-hospital mortality rate tended to be lower and the incidence of heart failure during hospitalization was significantly reduced in group B compared with group A [3.4% (5/149) vs. 6.5% (6/93), P > 0.05; 14.1% (21/149) vs. 24.7% (23/93), P < 0.05]. The length of hospital stay was slightly shortened from (8.98 ± 4.89) days to (7.79 ± 5.43) days (P > 0.05). Corrected mean medical cost went down by 9.4% (P < 0.05).
  
  
  CONCLUSIONS
  The establishment of CPC may significantly shorten the D-to-B time, improve the short-term outcome and reduce the hospitalization cost for PPCI patients with STEMI.
authors.affiliation: Department of Cardiology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou 510010, China. Email:dcxiang@foxmail.com.
authors.forename: Ding-cheng
authors.initials: DC
authors.lastname: Xiang
authors.forename: Tian-bing
authors.initials: TB
authors.lastname: Duan
authors.forename: Wei-yi
authors.initials: WY
authors.lastname: Qin
authors.forename: Wang-sheng
authors.initials: WS
authors.lastname: Luo
authors.forename: Jin-xia
authors.initials: JX
authors.lastname: Zhang
authors.forename: Shao-dong
authors.initials: SD
authors.lastname: Yi
authors.forename: Yun-jun
authors.initials: YJ
authors.lastname: Ruan
authors.forename: Hua
authors.initials: H
authors.lastname: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002637:Chest Pain / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D013997:Time Factors