Time to reperfusion in high-risk patients with myocardial infarction undergoing primary percutaneous coronary intervention

Abstract

Introduction: Timely reperfusion with primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) improves patient outcomes. In recent years, the Stent for Life (SFL) initiative in Portugal developed an action plan to improve timely access to PPCI. This study aims to evaluate performance indicators in high-risk populations (elderly, female, and diabetic patients). Methods: Data on 1340 patients with suspected STEMI who were admitted to 18 Portuguese interventional cardiology centers were collected during a one-month period every year from 2011 to 2016. The risk of longer patient and system delay in elderly, female, and diabetic patients was assessed by logistic regression analysis. Results: Patient and system delays were longer in elderly patients (incremental median 32 and 40 min; p=0.001 and p90 min (OR 2.95; 95% CI 1.84-4.72; p 90 min» (OR 2,95; IC95% 1,84-4,72; p < 0,001). Conclusão: Os idosos apresentaram maior atraso do doente e do sistema, independentemente do género e da presença de diabetes mellitus. Esses dados sugerem que o subgrupo dos idosos deve ser alvo de uma nova ação da Iniciativa SFL. Keywords: ST-segment elevation myocardial infarction, Stent for Life, Patient and system delay, Elderly, Women, Diabetes, Palavras-chave: Enfarte agudo do miocárdio com supradesnivelamento do segmento ST, Stent for Life, Atraso do doente e do sistema, Idosos, Mulheres, Diabéticos