Association between prehospital electrocardiogram use and patient home distance from the percutaneous coronary intervention center on total reperfusion time in ST-segment-elevation myocardial infarction patients

A retrospective analysis from the National Cardiovascular Data Registry

Bryn Mumma, Michael C. Kontos, S. Andrew Peng, Deborah B. Diercks

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Current guidelines recommend ≤90 minutes from first medical contact to percutaneous coronary intervention (FMC2B) for ST-segment-elevation myocardial infarction (STEMI) patients. We evaluated the relationship between patient home distance from a percutaneous coronary intervention (PCI) center, prehospital electrocardiogram (ECG) use, and FMC2B time among patients with STEMI. Methods We performed a retrospective cohort study including all STEMI patients in the ACTION - Get With The Guidelines registry from July 1, 2008, to September 30, 2012, who were transported by ambulance to a PCI center. Patient home distance was defined as the driving distance from the patient's home zip code to the PCI center address. Distance was classified into tertiles, and linear regression was used to characterize the interaction between prehospital ECG use and patient home distance with respect to FMC2B time. Results Of the 29,506 STEMI patients, 19,690 (67%) received a prehospital ECG. The median patient home distance to the PCI center was 11.0 miles among patients with and 9.9 miles among those without a prehospital ECG. Prehospital ECGs were associated with a 10-minute reduction in the FMC2B time (P lt.0001), which was consistent across distance tertiles (11 vs 11 vs 10 minutes). The association between prehospital ECGs and shorter FMC2B was attenuated by 0.8 minute for every 10-mile increase in distance (interaction P =.0002). Conclusions Prehospital ECGs are associated with a 10-minute reduction in the FMC2B time. However, patient home distance from a PCI center does not substantially change this association.

Original languageEnglish (US)
Pages (from-to)915-920
Number of pages6
JournalAmerican Heart Journal
Volume167
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Percutaneous Coronary Intervention
Reperfusion
Registries
Electrocardiography
ST Elevation Myocardial Infarction
Guidelines
Ambulances
Linear Models
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{6003fe44a5c14625a5bf08ec2937dc96,
title = "Association between prehospital electrocardiogram use and patient home distance from the percutaneous coronary intervention center on total reperfusion time in ST-segment-elevation myocardial infarction patients: A retrospective analysis from the National Cardiovascular Data Registry",
abstract = "Background Current guidelines recommend ≤90 minutes from first medical contact to percutaneous coronary intervention (FMC2B) for ST-segment-elevation myocardial infarction (STEMI) patients. We evaluated the relationship between patient home distance from a percutaneous coronary intervention (PCI) center, prehospital electrocardiogram (ECG) use, and FMC2B time among patients with STEMI. Methods We performed a retrospective cohort study including all STEMI patients in the ACTION - Get With The Guidelines registry from July 1, 2008, to September 30, 2012, who were transported by ambulance to a PCI center. Patient home distance was defined as the driving distance from the patient's home zip code to the PCI center address. Distance was classified into tertiles, and linear regression was used to characterize the interaction between prehospital ECG use and patient home distance with respect to FMC2B time. Results Of the 29,506 STEMI patients, 19,690 (67{\%}) received a prehospital ECG. The median patient home distance to the PCI center was 11.0 miles among patients with and 9.9 miles among those without a prehospital ECG. Prehospital ECGs were associated with a 10-minute reduction in the FMC2B time (P lt.0001), which was consistent across distance tertiles (11 vs 11 vs 10 minutes). The association between prehospital ECGs and shorter FMC2B was attenuated by 0.8 minute for every 10-mile increase in distance (interaction P =.0002). Conclusions Prehospital ECGs are associated with a 10-minute reduction in the FMC2B time. However, patient home distance from a PCI center does not substantially change this association.",
author = "Bryn Mumma and Kontos, {Michael C.} and Peng, {S. Andrew} and Diercks, {Deborah B.}",
year = "2014",
doi = "10.1016/j.ahj.2014.03.014",
language = "English (US)",
volume = "167",
pages = "915--920",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Association between prehospital electrocardiogram use and patient home distance from the percutaneous coronary intervention center on total reperfusion time in ST-segment-elevation myocardial infarction patients

T2 - A retrospective analysis from the National Cardiovascular Data Registry

AU - Mumma, Bryn

AU - Kontos, Michael C.

AU - Peng, S. Andrew

AU - Diercks, Deborah B.

PY - 2014

Y1 - 2014

N2 - Background Current guidelines recommend ≤90 minutes from first medical contact to percutaneous coronary intervention (FMC2B) for ST-segment-elevation myocardial infarction (STEMI) patients. We evaluated the relationship between patient home distance from a percutaneous coronary intervention (PCI) center, prehospital electrocardiogram (ECG) use, and FMC2B time among patients with STEMI. Methods We performed a retrospective cohort study including all STEMI patients in the ACTION - Get With The Guidelines registry from July 1, 2008, to September 30, 2012, who were transported by ambulance to a PCI center. Patient home distance was defined as the driving distance from the patient's home zip code to the PCI center address. Distance was classified into tertiles, and linear regression was used to characterize the interaction between prehospital ECG use and patient home distance with respect to FMC2B time. Results Of the 29,506 STEMI patients, 19,690 (67%) received a prehospital ECG. The median patient home distance to the PCI center was 11.0 miles among patients with and 9.9 miles among those without a prehospital ECG. Prehospital ECGs were associated with a 10-minute reduction in the FMC2B time (P lt.0001), which was consistent across distance tertiles (11 vs 11 vs 10 minutes). The association between prehospital ECGs and shorter FMC2B was attenuated by 0.8 minute for every 10-mile increase in distance (interaction P =.0002). Conclusions Prehospital ECGs are associated with a 10-minute reduction in the FMC2B time. However, patient home distance from a PCI center does not substantially change this association.

AB - Background Current guidelines recommend ≤90 minutes from first medical contact to percutaneous coronary intervention (FMC2B) for ST-segment-elevation myocardial infarction (STEMI) patients. We evaluated the relationship between patient home distance from a percutaneous coronary intervention (PCI) center, prehospital electrocardiogram (ECG) use, and FMC2B time among patients with STEMI. Methods We performed a retrospective cohort study including all STEMI patients in the ACTION - Get With The Guidelines registry from July 1, 2008, to September 30, 2012, who were transported by ambulance to a PCI center. Patient home distance was defined as the driving distance from the patient's home zip code to the PCI center address. Distance was classified into tertiles, and linear regression was used to characterize the interaction between prehospital ECG use and patient home distance with respect to FMC2B time. Results Of the 29,506 STEMI patients, 19,690 (67%) received a prehospital ECG. The median patient home distance to the PCI center was 11.0 miles among patients with and 9.9 miles among those without a prehospital ECG. Prehospital ECGs were associated with a 10-minute reduction in the FMC2B time (P lt.0001), which was consistent across distance tertiles (11 vs 11 vs 10 minutes). The association between prehospital ECGs and shorter FMC2B was attenuated by 0.8 minute for every 10-mile increase in distance (interaction P =.0002). Conclusions Prehospital ECGs are associated with a 10-minute reduction in the FMC2B time. However, patient home distance from a PCI center does not substantially change this association.

UR - http://www.scopus.com/inward/record.url?scp=84901770880&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901770880&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2014.03.014

DO - 10.1016/j.ahj.2014.03.014

M3 - Article

VL - 167

SP - 915

EP - 920

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 6

ER -