Abstract 4511: Wireless Technology Improves Outcomes and Eliminates Gender Bias in Acute Myocardial Infarction
Background Recent studies demonstrate women who present with ST elevation myocardial infarctions (STEMI) are more likely to experience delays in treatment and worse outcomes. We previously reported a fully automated wireless network (STAT-MI) for transmission of ECGs for suspected STEMI from the field to offsite cardiologists allowing early triage and shortening door to intervention (D2I) times. We now report the impact of the STAT-MI network in eliminating gender bias in patients with STEMI.
Methods The STAT-MI network was developed to enable automatic 12-lead ECG transmission and direct communication between EMS personnel and offsite cardiologists facilitating direct triage of patients to the cardiac catheterization lab. Demographics, laboratory and time interval data were prospectively collected and compared to concurrent control patients who presented with STEMI through non-STAT-MI pathways.
Results From June 2006 through December 2008, 93 patients (65 Male, 28 Female) presented via the STAT-MI network, and 52 patients (28 Male, 24 Female) presented through non-STAT-MI pathways (control group). Baseline clinical and demographic variables were similar in both groups and according to gender. Among controls, women tended to have longer D2I times compared to men (198±149 vs. 134±59 minutes, p=0.08). Overall, compared to controls, STAT-MI patients had significantly shorter D2I times (67±31 vs. 162±112 minutes, p<0.000001) that were similar between women and men (74±33 vs. 65±30, p=0.27). STAT-MI patients as compared to controls had significantly lower peak troponin I (74.2±75.9 vs. 111.9±82.9 ng/ml, p=0.023), higher ejection fractions (47.3±15.7 vs. 38.18±15.2%, p=0.002) and shorter length of stay (3.5±2.5 vs. 5.6±2.8 days, p=0.0001), observations that were similar between men and women.
Conclusions A fully automated, field based, wireless network that transmits ECGs automatically to offsite cardiologists for the early evaluation and triage of patients with STEMI shortens D2I times, reduces infarct size, limits EF reduction and shortens length of stay. These clinical improvements were observed equally between men and women and offer an opportunity to eliminate gender bias in the treatment of acute myocardial infarction.