Abstract

MARIANI, Javier; DE ABREU, Maximiliano  and  D. TAJER, Carlos. Time to and Use of Reperfusion Therapy in a Health Care Network. Rev. argent. cardiol. [online]. 2013, vol.81, n.3, pp.233-239. ISSN 1850-3748.

Introduction Time delays to reperfusion therapy in the acute phase of myocardial infarction are associated with lower treatment efficacy. Shortening these delays requires recognizing the specific time components in each system of care. Objectives The aim of this study was to analyze the use of reperfusion therapy and the time components in its implementation in a network of public hospitals. Methods Patients with acute coronary syndromes admitted to the coronary care unit of the Hospital El Cruce were included in this observational, prospective study. Patients with acute myocardial infarction were included for the description of time intervals. Results During the study period, 327 patients with acute myocardial infarction were hospitalized. Reperfusion therapy was administered to 63.6% of patients (65.9% were treated with fibrinolytics and 34.1% underwent primary percutaneous intervention). Time to consultation was 60 minutes (interquartile range: 30 to 180 minutes). Door-to-needle time was 75 minutes (45 to 121 minutes). The time from the first electrocardiogram to balloon inflation in patients transferred for primary percutaneous coronary intervention was 240 minutes (154 to 390 minutes) and was longer in patients transferred from hospitals outside the network (p < 0.016). Conclusions The use of reperfusion therapy is suboptimal, with prolonged time delays in the health care system. Both aspects have been considered in a network-based myocardial infarction care protocol and this study constitutes a baseline for the evaluation of future results.

Keywords : Myocardial Infarction; Coronary Angioplasty; Fibrinolytics; Registry.

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