Abstract 4694: Shipping Infarcts for Primary Angioplasty in Eastern Melbourne. SHIPEM Registry: Is it Possible to Achieve Guideline Door to Balloon Times?
Background: Primary PCI when performed in a timely manner is the preferred strategy for the treatment of STEMI patients. The current AHA/ACC and ESC guidelines recommend that primary PCI be performed within 90 minutes from arrival at a PCI capable hospital. The D2B (Door to Balloon) Alliance in the US recommends 75% of patients achieve this target timeframe. European guidelines also state that patients transferred from a non-PCI hospital should have a D2B time <120 minutes from first medical contact.
Method: We prospectively collected data (30-day and 1 year follow-up) on patients undergoing primary PCI at Box Hill Hospital (BHH) over 6 years to determine if we met these guidelines. We excluded rescue and facilitated PCI patients.
Results: Five hundred and seventy eight patients were in the BHH group (PCI center) and 188 were in the SHIPEM group (transferred from non-PCI center). The overall median D2B time (IQR) for BHH was 89 minutes (67,107) and 129 minutes (104,160) for SHIPEM. Fifty three percent of the BHH patients were treated within 90 minutes and 43% of the SHIPEM patients were treated within 120 minutes. Procedural success was similar for both groups. There was a significantly higher 30-day MACE, 1 year MACE, and 1 year mortality for the BHH patients with a D2B >90 minutes (p<0.05)*.
Conclusion: This real world registry shows that patients treated within the time limits recommended by guidelines have superior outcomes. Improvements in D2B times such as field ECG triage may help to meet the guidelines by increasing the percentage of patients achieving target D2B times.