Institutional members access full text with Ovid®

Share this article on:

Care quality monitoring of a ST-segment elevation myocardial infarction programme over a 5-year period

Meloni, Luigi; Floris, Roberto; Montisci, Roberta; De Candia, Gianfranco; Cadeddu, Mauro; Lai, Giorgio; Sori, Pierpaolo; Ruscazio, Massimo; Pinna, Giancarlo; Iasiello, Giuseppe; Pirisi, Raimondo

Journal of Cardiovascular Medicine: July 2016 - Volume 17 - Issue 7 - p 494–500
doi: 10.2459/JCM.0000000000000285
Quality of care

Aims The aim of this study is to investigate the long-term impact of a prehospital ECG programme on treatment times for patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

Methods From January 2008 to December 2012, 213 STEMI patients transported by the Emergency Medical System (EMS) underwent primary PCI in our Hospital. The protocol included ECG tele-transmission, early activation of the cath lab and direct routing of the patient for primary PCI. Fifty-four patients referred by EMS in 2007, when ECG tele-transmission was unavailable, were used as controls. First diagnostic ECG-to-balloon time, door-to-balloon time and total ischemic time were collected for all patients.

Results First diagnostic ECG-to-balloon time decreased from 125.5 min in 2007 to 104 min in the first year after implementation of the STEMI programme (2008). Successively, it declined to 81 min by the end of the study period (2012) (P < 0.0001). Door-to-balloon time decreased notably from 92.5 min in 2007 to 40.5 min by the end of the study period (p < 0.0001). Total ischemic time fell from 200 min in 2007 to 170 min in 2008 and it further declined to 163.5 min in 2012 (p < 0.042).

Conclusions We report progressive improvements in times to treatment over a 5-year period in a STEMI program for patients referred by the EMS. The importance of data collection and monitoring is highlighted by our results.

aClinical Cardiology, Department of Emergency Medicine, San Giovanni di Dio Hospital, University of Cagliari

b118 Emergency Medical Service, Cagliari, Italy

Correspondence to Prof. Luigi Meloni, Clinica Cardiologica, Ospedale San Giovanni di Dio, Università di Cagliari, Cagliari, Italy Tel: +39 70 6092236; fax: +39 70 662747; e-mail:

Received 21 October, 2014

Revised 10 March, 2015

Accepted 4 April, 2015

© 2016 Italian Federation of Cardiology. All rights reserved.