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Prehospital 12-lead ECG to triage ST-elevation myocardial infarction and emergency department activation of the infarct team significantly improves door-to-balloon times: ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG project.
Circ Cardiovasc Interv. 2009 Dec; 2(6):528-34.CC

Abstract

BACKGROUND

American College of Cardiology/American Heart Association guidelines recommend >75% of patients with an ST-elevation myocardial infarction receive primary percutaneous coronary interventions (PPCI) within 90 minutes. Despite these recommendations, this goal has been difficult to achieve.

METHODS AND RESULTS

We conducted a prospective interventional study involving 349 patients undergoing PPCI at a single tertiary referral institution to determine the impact of prehospital 12-lead ECG triage and emergency department activation of the infarct team on door-to-balloon time (D2BT). The median D2BT of all patients (n=107) who underwent PPCI after field ECG and emergency department activation of the infarct team (MonashHEART Acute Myocardial Infarction [MonAMI] group) was 56 minutes (interquartile range, 36.5 to 70) compared with the median time of a contemporary group (n=122) undergoing PPCI during the same period but not receiving field triage (non-MonAMI group) of 98 minutes (73 to 126.45). The median D2BT time of 120 consecutive patients who underwent PPCI before initiation of the project (pre-MonAMI group) was 101.5 minutes (72.5 to 134; P<0.001). The proportion of patients who achieved a D2BT of < or = 90 minutes increased from 39% in the pre-MonAMI group and 45% in the non-MonAMI group to 93% in the MonAMI group (P<0.001).

CONCLUSIONS

The performance of prehospital 12-lead ECG triage and emergency department activation of the infarct team significantly improves D2BT and results in a greater proportion of patients achieving guideline recommendations.

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Authors+Show Affiliations

Hutchison AW
Monash Cardiovascular Research Centre, Monash University, Australia.
Malaiapan Y
No affiliation info available
Jarvie I
No affiliation info available
Barger B
No affiliation info available
Watkins E
No affiliation info available
Braitberg G
No affiliation info available
Kambourakis T
No affiliation info available
Cameron JD
No affiliation info available
Meredith IT
No affiliation info available

MeSH

AgedAmbulancesAngioplasty, Balloon, CoronaryAustraliaElectrocardiographyEmergency Medical ServicesEmergency Service, HospitalFemaleGuideline AdherenceHealth Services AccessibilityHumansMaleMiddle AgedMyocardial InfarctionPatient Care TeamPilot ProjectsPractice Guidelines as TopicPredictive Value of TestsProgram EvaluationProspective StudiesTime FactorsTriage

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20031770

Citation

Hutchison, Adam W., et al. "Prehospital 12-lead ECG to Triage ST-elevation Myocardial Infarction and Emergency Department Activation of the Infarct Team Significantly Improves Door-to-balloon Times: Ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG Project." Circulation. Cardiovascular Interventions, vol. 2, no. 6, 2009, pp. 528-34.
Hutchison AW, Malaiapan Y, Jarvie I, et al. Prehospital 12-lead ECG to triage ST-elevation myocardial infarction and emergency department activation of the infarct team significantly improves door-to-balloon times: ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG project. Circ Cardiovasc Interv. 2009;2(6):528-34.
Hutchison, A. W., Malaiapan, Y., Jarvie, I., Barger, B., Watkins, E., Braitberg, G., Kambourakis, T., Cameron, J. D., & Meredith, I. T. (2009). Prehospital 12-lead ECG to triage ST-elevation myocardial infarction and emergency department activation of the infarct team significantly improves door-to-balloon times: ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG project. Circulation. Cardiovascular Interventions, 2(6), 528-34. https://doi.org/10.1161/CIRCINTERVENTIONS.109.892372
Hutchison AW, et al. Prehospital 12-lead ECG to Triage ST-elevation Myocardial Infarction and Emergency Department Activation of the Infarct Team Significantly Improves Door-to-balloon Times: Ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG Project. Circ Cardiovasc Interv. 2009;2(6):528-34. PubMed PMID: 20031770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prehospital 12-lead ECG to triage ST-elevation myocardial infarction and emergency department activation of the infarct team significantly improves door-to-balloon times: ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG project. AU - Hutchison,Adam W, AU - Malaiapan,Yuvaraj, AU - Jarvie,Ian, AU - Barger,Bill, AU - Watkins,Edward, AU - Braitberg,George, AU - Kambourakis,Tony, AU - Cameron,James D, AU - Meredith,Ian T, Y1 - 2009/12/01/ PY - 2009/12/25/entrez PY - 2009/12/25/pubmed PY - 2010/3/6/medline SP - 528 EP - 34 JF - Circulation. Cardiovascular interventions JO - Circ Cardiovasc Interv VL - 2 IS - 6 N2 - BACKGROUND: American College of Cardiology/American Heart Association guidelines recommend >75% of patients with an ST-elevation myocardial infarction receive primary percutaneous coronary interventions (PPCI) within 90 minutes. Despite these recommendations, this goal has been difficult to achieve. METHODS AND RESULTS: We conducted a prospective interventional study involving 349 patients undergoing PPCI at a single tertiary referral institution to determine the impact of prehospital 12-lead ECG triage and emergency department activation of the infarct team on door-to-balloon time (D2BT). The median D2BT of all patients (n=107) who underwent PPCI after field ECG and emergency department activation of the infarct team (MonashHEART Acute Myocardial Infarction [MonAMI] group) was 56 minutes (interquartile range, 36.5 to 70) compared with the median time of a contemporary group (n=122) undergoing PPCI during the same period but not receiving field triage (non-MonAMI group) of 98 minutes (73 to 126.45). The median D2BT time of 120 consecutive patients who underwent PPCI before initiation of the project (pre-MonAMI group) was 101.5 minutes (72.5 to 134; P<0.001). The proportion of patients who achieved a D2BT of < or = 90 minutes increased from 39% in the pre-MonAMI group and 45% in the non-MonAMI group to 93% in the MonAMI group (P<0.001). CONCLUSIONS: The performance of prehospital 12-lead ECG triage and emergency department activation of the infarct team significantly improves D2BT and results in a greater proportion of patients achieving guideline recommendations. SN - 1941-7632 UR - https://www.unboundmedicine.com/medline/citation/20031770/Prehospital_12_lead_ECG_to_triage_ST_elevation_myocardial_infarction_and_emergency_department_activation_of_the_infarct_team_significantly_improves_door_to_balloon_times:_ambulance_Victoria_and_MonashHEART_Acute_Myocardial_Infarction__MonAMI__12_lead_ECG_project_ L2 - https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.109.892372?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓6]

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