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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
B. Imaging
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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15. Valvular Heart Disease
16. Infective Endocarditis
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19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Impact of door in-door out time in total ischemic time and prognosis in Acute Myocardial Infarction
Session:
Posters 3 - Écran 1 - Doença Coronária
Speaker:
Cátia Costa Oliveira
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Posters
FP Number:
---
Authors:
Cátia Costa Oliveira; Miguel Afonso; Isabel Durães Campos; Carla Rodrigues; Paulo Medeiros; Rui Files Flores; João Costa; Carlos Galvão Braga; Jorge Marques
Abstract
<p><strong>Introduction:</strong> Patients with ST elevation myocardial infarction (STEMI) requiring interhospital transfer for primary Percutaneous Coronary Intervention (PCI) often have delays in reperfusion. The door in-door out time (DIDO), which corresponds to the duration of time from arrival to discharge at the first hospital is increasingly being advocated as an important measure that must be considered in the processes aimed at accelerating reperfusion. DIDO is recommended to be less than 30 minutes.</p> <p><strong>Aims: </strong>Evaluate DIDO time of the hospitals that transfer patients with STEMI to a center with primary-PCI. To assess the impact of DIDO time on total ischemia time and clinical outcomes in patients with STEMI.</p> <p><strong>Methods:</strong> Retrospective study with 523 patients with STEMI transferred to a center with primary PCI between January 1, 2013 and June 30, 2017.</p> <p><strong>Results:</strong> Median DIDO time was 82 minutes (interquartile range, 61-132 minutes). Only 7 patients (1.3%) were transfered in 30 minutes or less. Patients with DIDO times greater than 60 minutes had system delays (207.3min. vs 112.7min.; <em>p</em><.001) and total ischemia time (344.2min. vs 222min.; p<.001) significantly higher when compared to the patients transferred in 60 minutes or less. Observed in-hospital mortality was significantly higher among patients with DIDO times greater than 60 minutes vs patients with DIDO times of 60 minutes or less (5.1% vs 0%; <em>p</em>=.006; adjusted odds ratio for in-hospital mortality, 1.27 [95% CI, 1.062-1.432]). Until the date of follow-up, patients belonging to the group “>60min” had a higher proportion of death events, <em>p</em> = .016, and the survival time was significantly lower, <em>p</em> = .011.</p> <p><strong>Conclusion:</strong> A DIDO time of 30 minutes or less was observed in a small proportion of patients transferred for primary PCI. DIDO times of 60 minutes or less were associated with lower delays in reperfusion, lower in-hospital mortality and longer survival times.</p>
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