Comparison of Time to Perform Primary Percutaneous Intervention in the Capital and a Provincial Capital

Abstract

Introduction: For those with ST-segment myocardial infarction (STEMI), therapeutic delays are the leading cause of mortality. Contacting a health-care provider takes longer than the emergent prehospital system, the patient referral process, the emergency room, and within the hospital. In our nation’s various cities, we aimed to compare these variables. Methods: In the Iranian cities of Sanandaj and Tehran, the Rajaie Cardiovascular Medical and Research Center (RHC) and Tohid Hospital, respectively, undertook this multicenter, multiprefectural, cross-sectional study between 2016 and 2020. Baseline characteristics were gathered from medical records, including age, sex, and employment. In two centers, the first medical contact-to-door (FTD) and door-to-balloon (DTB) times as well as electrocardiographic abnormalities, adjunctive therapy, causal lesions, and FTD and DTB times were evaluated. Results: The study population consisted of 600 STEMI patients, 300 from each institutions. Most of the participants were male, approximately a third of the patients arrived at the hospital using emergency medical service, the most frequent culprit artery in both hospitals was the left anterior descending artery, the average FTD was 333 min in Tehran and 151 min in Sanandaj, with the statistical significance difference (P < 0.001), DTB was significantly lower at RHC than at Tohid Hospital (54.8 min vs. 88.3 min; P < 0.001), the maximum FTD was observed among patients older than 70-year-old (284.72 min). Conclusion: Preparing sufficient facilities for primary percutaneous coronary intervention units, increasing the number of specialists and ensuring their permanent presence in hospitals, and providing health-care personnel with improved training may play significant roles in minimizing DTB.

Keywords

• door-to-balloon time
• primary percutaneous coronary intervention
• st-segment myocardial infarction