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Abstract: Poster Presentations |

INTERHOSPITAL TRANSFER OF PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION FOR PERCUTANEOUS CORONARY INTERVENTION FREE TO VIEW

Fausan S. Tsai, MD*; Wilbert S. Aronow; William M. Mellana, MD; Chul Ahn, PhD; Ambra Ferraris, MD; Majid Dudha, MD; Kumar Kalapatapu, MD; Anthony L. Pucillo, MD; Craig E. Monsen, MD
Author and Funding Information

New York Medical College, Valhalla, NY


Chest


Chest. 2009;136(4_MeetingAbstracts):108S. doi:10.1378/chest.136.4_MeetingAbstracts.108S-a
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Abstract

PURPOSE:  To investigate in patients with ST-segment elevation acute myocardial infarction (STEMI) transferred from community hospitals to a percutaneous coronary intervention (PCI) center the incidences of in-hospital mortality, stroke, and recurrent myocardial infarction (MI) associated with transfer times.

METHODS:  We investigated in 277 consecutive patients, mean age 63 years, with STEMI transferred from 25 community hospitals to a PCI center from a median distance of 21 miles the incidences of in-hospital mortality, stroke, and recurrent MI associated with transfer times. Of the 277 patients, 158 (57%) had thrombolytic therapy at the referring hospital. Of the 277 patients, 63 (23%) had adjunctive PCI, 119 (43%) had primary PCI, and 95 (34%) had rescue PCI. Of the 277 patients, 42 (15%) were hemodynamically unstable.

RESULTS:  Median transfer times were 102 minutes with primary PCI, 119 minutes with rescue PCI, and 144 minutes for adjunctive PCI (p < 0.0001 for adjunctive PCI versus primary PCI; p = 0.011 for adjunctive PCI versus rescue PCI). Median transfer time was 98 minutes for hemodynamically unstable patients and 121 minutes for hemodynamically stable patients (p = 0.005). In-hospital death occurred in 8 of 277 patients (3%). In-hospital stroke occurred in 3 of 277 patients (1%). In-hospital recurrent nonfatal MI occurred in none of 277 patients (0%). There was no association of transfer times with in-hospital mortality or stroke. In-hospital mortality occurred in 3 of 112 patients (3%) who had bare-metal stents and in 5 of 165 patients (3%) who had drug-eluting stents.In-hospital mortality and stroke were not significantly different among those who had adjunctive, primary, or rescue PCI.

CONCLUSION:  In patients with STEMI transferred for PCI, there was no association of transfer times with in-hospital mortality, stroke, and recurrent nonfatal MI. In-hospital mortality, stroke, and recurrent nonfatal MI were not significantly different among those who had adjunctive, primary, or rescue PCI.

CLINICAL IMPLICATIONS:  Patients with STEMI transferred from community hospitals to a PCI center for adjunctive, primary, or rescue PCI have a low incidence of in-hospital mortality, stroke, and recurrent nonfatal MI.

DISCLOSURE:  Fausan Tsai, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM


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