Abstract 13956: The Effect of Transfer Distance on Reperfusion Time of ST-Elevation Patients Transferred for Primary Percutaneous Coronary Intervention
Background: Regional ST-elevation myocardial infarction (STEMI) care systems were designed to decrease delays in reperfusion of STEMI patients.
Aim: This study aimed to explore the time line for reperfusion and its effect on outcome in patients transferred to a PCI capable center at long and short distances.
Methods: “CodeHeart” is a regional STEMI care system in the greater Washington DC area aimed at prompt reperfusion of STEMI patients. Efforts to improve reperfusion time included among others, a designated cellular-phone application allowing ECG sharing and consultation with the referring physician. Within the group of transferred patients (n=1,065), 609 (57%) patients were transferred from a distance >25 miles (GT25; median distance 36 miles) while 456 (43%) were transferred from distances of ≤25 miles (LT25; median distance 13 miles).
Results: Baseline characteristics were mostly similar except for more men and Caucasians in the GT25 group (70.9% vs. 64.9%; p=0.36 & 81% vs. 43.2%; p <0.001, respectively), alongside a higher prevalence of heart failure history in the LT25 group (11.4% vs. 7.6%; p=0.036). Median transfer distance was 28 miles. No differences were noted in the median door-to-balloon time (GT25:158 min [122-213] vs.149 [118-219]; p=0.5) or in in-hospital mortality (8% vs. 7.2%; p=0.617). By implementing the “CodeHeart” network, a constant decrease in door-to-balloon was noted along the years of operation. (Figure)
Conclusion: A network transfer system for primary PCI mitigates the distance factor on the door-to-balloon time and mortality in patients presented with STEMI to remote emergency rooms and transferred to a PCI capable center.
- © 2013 by American Heart Association, Inc.