title: Effective Factors in Door-to-Needle Time for Streptokinase Administration in Patients With Acute Myocardial Infarction Admitted to the Emergency Department.
abstract: BACKGROUND
  Cardiovascular incidents are a common cause of death around the world. Acute myocardial infarction (AMI) poses high risks for the patient due to plaque rupture or erosion along with a superimposed non-occlusive thrombus; therefore, timely treatment with antithrombotic agents plays a key role in reducing an AMI mortality rate.
  
  
  OBJECTIVE
  The present study aimed to assess the time interval between the admission of AMI-suspected patients and treatment initiation.
  
  
  METHODS
  This cross-sectional study was conducted on 110 patients admitted to the emergency department of Imam Hussein hospital in Tehran, Iran. Data were collected using checklists, completed by the patients' next of kin or the emergency staff. To analyze the data, student t- test and analysis of variance were used.
  
  
  RESULTS
  In this study, 31 female and 79 male subjects were included, respectively. The mean time to receive the first dose of streptokinase was 66.39 minutes (73.74 minutes for females and 63.5 minutes for male patients), varying from 49.92 minutes in the morning to 69.78 minutes in the afternoon and 72.68 minutes during night shifts.
  
  
  CONCLUSIONS
  The door-to-needle (DTN) time, in a standard setting, is recommended to be less than 30 minutes. According to the results of this study, the DTN time is comparatively two times longer in females and afternoon and night shifts. Different variables including emergency staff, physicians, patients' characteristics, and environmental/physical factors induced this difference.
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, AJA University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Omraninava
authors.affiliation: Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Amir Masoud
authors.initials: AM
authors.lastname: Hashemian
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Masoumi
keywords: Acute Myocardial Infarction; Emergency Service; Needle Stick Injuries; Streptokinase