First medical contact to balloon time in primary percutaneous coronary intervention for ST-elevation myocardial infarction and its influencing factors / 中国介入心脏病学杂志

ABSTRACT

Objective To investigate the first medical contact to balloon ( FMC2B) time in our center and to identify the influencing factors .Methods This is a retrospective study conducted in the heart center of Beijing Luhe Hospital . A total of 140 patients undergoing primary percutaneous coronary intervention ( PCI) were enrolled between July 2013 to September 2014.Demographic data , clinical risk factors and the emergency process were evaluated .All the patients were categorized into 2 groups includingthe conformed group ( patients with FMC2B<120 min for non-PCI-capable hospital and <90 min for direct arrival at Luhe hospital, n=59) and the unconformed group (n=81).Multivariant regression aralysis was done to analyse factors influencing FMC 2B time.Results Among the enrolled 140 patients, 58 patients were initially seen in a non-PCI-capable hospital , 31 patients were directly sent to Luhe hospital by ambulance and 51 patients arrived by themselves.The median FMC2B time was 106.16 min (interquartile range [ IQR ] 77.37 -165.52 min ) and 42.1% ( 59/140 ) of the patients achieved the current recommended FMC2B time.In a multivariate logistic analysis , FMC to electrocardiographic ( ECG) within 10 min ( OR=5.61 , 95% CI 1.91-16.88 ) , admission during normal working hours ( OR=5.11 , 95%CI 1.88-13.85 ) , patient′s education level of high school or above ( OR=4.16 , 95%CI 1.53-11.34 ) , awareness of heart diseases ( OR =2.58, 95% CI 1.13 -5.91 ) were predictors of improving FMC2B. Transfer for primary PCI (OR=0.37, 95% CI 0.15-0.92) increased FMC2B.Conclusions Less than half of the patients with primary PCI achieved the goal of guidelines′recommended FMC2B time.Initial ECG, admission during normal working hours , patient′s education level and awareness of heart diseases and transfer for primary PCI are the independent predictors of FMC 2B time.