Abstract 184: Acre ST-Segment Elevation Myocardial Infarction (STEMI) Registry (ASTEMIR): Interval Times Since Symptoms and Reperfusion Success
Proposal: STEMI treatment and its impact on outcomes are highly dependent on time since symptoms onset. We aimed to evaluate the time intervals between symptoms onset, emergency unit admission, electrocardiogram (EKG) and treatment or transfer to treatment thrombolytic therapy(TT) capable unit and their relation to reperfusion success in the public health system (SUS) of ACRE, Rio Branco, Brazil.
Method: The ASTEMIR(Jan 2010-Dec 2011) is the first Brazilian prospective TT registry to include community-based emergency units and general hospitals patients, with a more reliable record of the AMI care reality. It included consecutive STEMI admitted to 3 general hospitals and 8 community-based emergency units.
Results: 189 patients (61±12y, 54% males), with high prevalence of hypertension (71%), diabetes (33%) and previous AMI (13%). On admission, 81% had typical chest pain and 37% Killip class≥II. Half of the patients received TT with tenecteplase (median ambulance--to-needle 104min, IQR 87-207) or door-to-needle 289min, IQR 234-437 reperfusion. The general pain-to-admission time was 155min (76-324) and admission-to-EKG,162min (90-393). Both, pain-to-admission and admission-to-EKG were lower in the reperfusion group (110 vs 205 min,p=0.002, and 155 vs 220min,p=0.001,respectively).
Conclusion: Pain-to-admission and admission-to-EKG times are related to reperfusion success. Regardless of this, the interval times observed in Acre, Rio Branco are close to the ideal recommended by the guidelines. Improvements in population awareness for readily identificationof AMI and health professional education for higher suspicion of STEMI could meliorate this reality in Acre.
- © 2012 by American Heart Association, Inc.