ABSTRACT
Objective To determine whether field triage would reduce median contact-to-device ( C2D ) time in patients with ST-segment elevation acute myocardial infarction ( STEMI ) . Methods Consecutive patients with STEMI underwent primary percutaneous coronary intervention( PCI) from March 2010 to February 2014 in Shanghai Pudong Gongli Hospital were analyzed. Patients were divided into two groups. A total of 121 patients were admitted by field triage and 101 patients by non-field triage. The primary study point was C2D time and the study points secondary included ( door-to-balloor, D2B) time, peak Troponin I ( TnI) levels, hospital mortality and 30 days follow-up mortality. Results Baseline and procedural characteristics between the two groups were comparable. Comparing to non-field triage group, the C2D time was reduced [(92. 0 ± 56. 0)min vs. (131. 0 ± 61. 0)min,P﹤0. 01]. The D2B time was lower in the field triage group vs. the non-field triage group [(55. 0 ±26. 0)min vs. (96. 0 ±31. 0)min,P﹤0. 01]. The percentage of patients with C2D time less than 90 minutes increased significantly from 85. 1% to 98. 3%( P﹤0. 01 ) in the field triage group. Peak TnI level was significantly reduced in the field triage group [(23. 5 ±22. 0) μg/L vs. (43. 5 ± 39. 0) μg/L,P﹤0. 01]. In-hospital mortality and 30 days follow-up mortality did not significantly differ between the 2 groups (3. 3% and 3. 0%, P=0. 885;3. 3% and 5. 0%, P=0. 544, respectively). Conclusions In STEMI patients, field triage was associated with significantly reduced C2D and D2B times.
ABSTRACT
Objective To evaluate the effects of preventive cardiac pacing on acute inferior wall myocardiac infarction ( AIMI ) . Methods A total of 52 patients were given preventive cardiac pacing before Percutaneous coronary intervention (PCI) (group T),while another 68 patients were not (group N).Heart rate and average blood pressure level before reperfusion, average blood pressure level after reperfusion,TIMI flow grade before and after reperfusion,the incidence of malignant ventricular arrhythmia after reperfusion and adverse cardiovascular events during hospitalization were compared in two groups. Results There were no significant differences in heart rate before reperfusion , average blood pressure levels before and after reperfusion , and the TIMI flow grade before and after reperfusion between two groups. The malignant ventricular arrhythmia after reperfusion in group T was significantly higher than that in group N while heart failure and nonfatal myocardial infarction were no significantly different between them. Mortality rate and mortality rate of cardiovascular disease in group T were higher than those in group N, but there were no significant differences between them. Conclusions The temporary cardiac pacing has no additional preventive effect on hemodynamic , but increases the occurrence of malignant ventricular arrhythmia , and the risk of death and cardiovascular events.