STEMI notification by EMS predicts shorter door-to-balloon time and smaller infarct size.
BACKGROUND
Emergency medical services (EMS) transportation is associated with shorter door-to-balloon (DTB) time in patients with ST-segment elevation myocardial infarction (STEMI). In addition to EMS transportation, prehospital notification of STEMI by EMS to receiving hospital might be able to further shorten DTB time. We evaluated the impact of STEMI notification on DTB time as well as infarct size.


METHODS
We performed a retrospective analysis of consecutive patients with anterior wall STEMI who underwent emergent coronary angiography. We excluded patients who presented with cardiac arrest and those who were transferred from non-percutaneous coronary intervention-capable hospitals. Mode of transportation were categorized into the 3 groups: (1) EMS transport with STEMI notification, (2) EMS transport without STEMI notification, and (3) self-transport. Baseline characteristics, laboratory data, left ventricular ejection fraction (LVEF), and DTB time were compared among the 3 groups.


RESULTS
A total of 148 patients were included in the final analysis. Of the 148 patients, 56 patients arrived by EMS transport with STEMI notification, 56 patients arrived by EMS transport without STEMI notification, and 36 patients arrived by self-transport. Patients who arrived by EMS transport with STEMI notification had the shortest DTB time among the 3 groups. Patients who arrived by EMS transport with STEMI notification had smaller infarct size, as indicated by lower peak creatine kinase value and higher LVEF, compared with those who arrived by EMS transport without STEMI notification.


CONCLUSIONS
Emergency medical services transport with STEMI notification was associated with shorter DTB time and smaller infarct size in patients with anterior wall STEMI.
Department of Internal Medicine, Mount Sinai Beth Israel, New York. Electronic address: akobayashi@chpnet.org.
Akihiro
A
Kobayashi
Department of Internal Medicine, Mount Sinai Beth Israel, New York.
Naoki
N
Misumida
Department of Internal Medicine, Mount Sinai Beth Israel, New York.
Shunsuke
S
Aoi
Department of Emergency Medicine, Mount Sinai Beth Israel, New York.
Eric
E
Steinberg
Department of Cardiology, Mount Sinai Beth Israel, New York.
Kathleen
K
Kearney
Department of Cardiology, Mount Sinai Beth Israel, New York.
John T
JT
Fox
Department of Cardiology, Mount Sinai Beth Israel, New York.
Yumiko
Y
Kanei
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D012720:Severity of Illness Index; D013997:Time Factors; D061665:Time-to-Treatment / Q000592:standards*; D014187:Transportation of Patients / Q000592:standards*