Direct admission, shorter symptoms-to-admission time predict significantly lower 12-month mortality
THURSDAY, Feb. 16, 2017 (HealthDay News) — For patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI), direct admission to a primary PCI center is associated with lower 12-month mortality, according to a study published online Feb. 15 in JACC: Cardiovascular Interventions.
Using data from a prospective nationwide registry, Damian Kawecki, M.D., Ph.D., from the Medical University of Silesia in Poland, and colleagues examined the impact of direct admission versus transfer via regional hospital to a PCI center on time delays and 12-month mortality in STEMI patients. A total of 70,093 patients were eligible for analysis, of whom 56 percent were admitted directly to a PCI center.
The researchers found that direct admission correlated with a 44-minute shorter median symptoms-to-admission time (P < 0.001) and total ischemic time (228 versus 270 minutes; P < 0.001), higher left ventricle ejection fraction (47.5 versus 46.3 percent; P < 0.001), and lower propensity-matched 12-month mortality (9.6 versus 10.4 percent; P < 0.001). Direct admissions and shorter symptoms-to-admission time were significant predictors of lower 12-month mortality in propensity matched analysis (hazard ratios, 1.06 and 1.03, respectively).
“In a large, community-based cohort of patients with STEMI treated by PCI, direct admission to a primary PCI center was associated with lower 12-month mortality and should be preferred to transfer via a regional non-PCI-capable facility,” the authors write.
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