Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project
Objective: To analyze the impact of reperfusion by either primary percutaneous coronary intervention (PPCI) or fibrinolysis, and mortality rates of a pre-hospital fast-track network for treating patients with ST-elevation myocardial infarction (STEMI). Methods and Results: A pre-hospital network for...
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Elsevier
2012-03-01
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Series: | Revista Portuguesa de Cardiologia |
Online Access: | http://www.sciencedirect.com/science/article/pii/S0870255112000145 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Veloso Gomes Victor Brandão Jorge Mimoso Paula Gago Joana Trigo Walter Santos Nuno Marques Rui Candeias Salomé Pereira Vasco Marques Ana Camacho Ilídio de Jesus |
spellingShingle |
Veloso Gomes Victor Brandão Jorge Mimoso Paula Gago Joana Trigo Walter Santos Nuno Marques Rui Candeias Salomé Pereira Vasco Marques Ana Camacho Ilídio de Jesus Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project Revista Portuguesa de Cardiologia |
author_facet |
Veloso Gomes Victor Brandão Jorge Mimoso Paula Gago Joana Trigo Walter Santos Nuno Marques Rui Candeias Salomé Pereira Vasco Marques Ana Camacho Ilídio de Jesus |
author_sort |
Veloso Gomes |
title |
Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project |
title_short |
Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project |
title_full |
Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project |
title_fullStr |
Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project |
title_full_unstemmed |
Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve Project |
title_sort |
implementation of a pre-hospital network favoring primary angioplasty in stemi to reduce mortality: the algarve project |
publisher |
Elsevier |
series |
Revista Portuguesa de Cardiologia |
issn |
0870-2551 |
publishDate |
2012-03-01 |
description |
Objective: To analyze the impact of reperfusion by either primary percutaneous coronary intervention (PPCI) or fibrinolysis, and mortality rates of a pre-hospital fast-track network for treating patients with ST-elevation myocardial infarction (STEMI). Methods and Results: A pre-hospital network for STEMI patients, designated the Green Lane for Acute Myocardial Infarction (GL-AMI), has been implemented in the southern region of Portugal – the Algarve Project. We performed an observational study based on a prospective registry of 1338 patients admitted to Faro Hospital between 2004 and 2009, classified in two groups according to the method of admission: emergency department group (EDG) and GL-AMI group (GLG). More patients from GLG were reperfused (p < 0.0001). PPCI was the preferred method of reperfusion, 73.1% in GLG and 45.3% in EDG. Time delays were significantly shorter in GLG, except for pre-hospital delay: pre-hospital delay (p = 0.11); door-to-needle (p < 0.0001); door-to-balloon (p < 0.0001); and delay between symptoms and reperfusion (p < 0.0001). In-hospital mortality (4.3% vs 9.2%, p = 0.0007) and 6-month mortality (6.3% vs 13.8%, p < 0.0001) were significantly lower in GLG. Conclusions: The Algarve Project significantly reduced the time delay between onset of symptoms and reperfusion, significantly increased the rate of reperfusion, and significantly reduced in-hospital and six-month mortality. Resumo: Objetivo: Analisar o impacto nas taxas de reperfusão por intervenção coronária percutânea primária (PPCI) ou fibrinólise, e na mortalidade de uma rede pré-hospitalar para o tratamento de doentes com enfarte agudo do miocárdio com elevação do segmento ST. Métodos e Resultados: A rede pré-hospitalar para doentes com enfarte agudo do miocárdio, designada Via Verde para o Enfarte Agudo do Miocárdio (GW-AMI), tem sido implementada na região sul de Portugal - O Projeto Algarve. Realizamos um estudo observacional, baseado num registo prospetivo de 1338 doentes internados no Hospital de Faro entre 2004 e 2009, classificados em dois grupos de acordo com a forma de admissão: grupo do Serviço de Urgência (EDG) e grupo GW-AMI (GTG). Mais doentes do GTG foram reperfundidos (p < 0,0001). PPCI foi o método preferencial de reperfusão, 73,1% no GTG e 45,3% no EDG. Os tempos de demora foram significativamente inferiores no GTG, exceto o atraso pré-hospitalar: Tempo pré-hospitalar (p = 0,11); Porta-agulha (p < 0,0001); Porta-balão (p < 0,0001); Tempo sintomas-reperfusão (p < 0,0001). As taxas de mortalidade hospitalar (4,3% versuss 9,2%, p = 0,0007) e mortalidade aos 6 meses (6,3% versus 13,8%, p < 0,0001) foram significativamente inferiores no GTG. Conclusões: O Projeto Algarve reduziu significativamente os tempos de demora entre o início dos sintomas e reperfusão, aumentou significativamente a taxa de reperfusão e diminuiu significativamente as taxas de mortalidade hospitalar e aos seis meses. Keywords: ST-elevation myocardial infarction, Treatment delays, Reperfusion therapy, Pre-hospital clinical network, Mortality, Palavras-chave: Enfarte agudo do miocárdio com elevação do segmento ST, Tempos de demora, Terapia de reperfusão, Rede pré-hospital, Mortalidade |
url |
http://www.sciencedirect.com/science/article/pii/S0870255112000145 |
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doaj-a9f7d7389aa340c1a866d08beaab3d0e2020-11-25T02:56:45ZengElsevierRevista Portuguesa de Cardiologia0870-25512012-03-01313193201Implementation of a pre-hospital network favoring primary angioplasty in STEMI to reduce mortality: The Algarve ProjectVeloso Gomes0Victor Brandão1Jorge Mimoso2Paula Gago3Joana Trigo4Walter Santos5Nuno Marques6Rui Candeias7Salomé Pereira8Vasco Marques9Ana Camacho10Ilídio de Jesus11Corresponding author.; Department of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalDepartment of Cardiology, Faro Hospital, Faro, PortugalObjective: To analyze the impact of reperfusion by either primary percutaneous coronary intervention (PPCI) or fibrinolysis, and mortality rates of a pre-hospital fast-track network for treating patients with ST-elevation myocardial infarction (STEMI). Methods and Results: A pre-hospital network for STEMI patients, designated the Green Lane for Acute Myocardial Infarction (GL-AMI), has been implemented in the southern region of Portugal – the Algarve Project. We performed an observational study based on a prospective registry of 1338 patients admitted to Faro Hospital between 2004 and 2009, classified in two groups according to the method of admission: emergency department group (EDG) and GL-AMI group (GLG). More patients from GLG were reperfused (p < 0.0001). PPCI was the preferred method of reperfusion, 73.1% in GLG and 45.3% in EDG. Time delays were significantly shorter in GLG, except for pre-hospital delay: pre-hospital delay (p = 0.11); door-to-needle (p < 0.0001); door-to-balloon (p < 0.0001); and delay between symptoms and reperfusion (p < 0.0001). In-hospital mortality (4.3% vs 9.2%, p = 0.0007) and 6-month mortality (6.3% vs 13.8%, p < 0.0001) were significantly lower in GLG. Conclusions: The Algarve Project significantly reduced the time delay between onset of symptoms and reperfusion, significantly increased the rate of reperfusion, and significantly reduced in-hospital and six-month mortality. Resumo: Objetivo: Analisar o impacto nas taxas de reperfusão por intervenção coronária percutânea primária (PPCI) ou fibrinólise, e na mortalidade de uma rede pré-hospitalar para o tratamento de doentes com enfarte agudo do miocárdio com elevação do segmento ST. Métodos e Resultados: A rede pré-hospitalar para doentes com enfarte agudo do miocárdio, designada Via Verde para o Enfarte Agudo do Miocárdio (GW-AMI), tem sido implementada na região sul de Portugal - O Projeto Algarve. Realizamos um estudo observacional, baseado num registo prospetivo de 1338 doentes internados no Hospital de Faro entre 2004 e 2009, classificados em dois grupos de acordo com a forma de admissão: grupo do Serviço de Urgência (EDG) e grupo GW-AMI (GTG). Mais doentes do GTG foram reperfundidos (p < 0,0001). PPCI foi o método preferencial de reperfusão, 73,1% no GTG e 45,3% no EDG. Os tempos de demora foram significativamente inferiores no GTG, exceto o atraso pré-hospitalar: Tempo pré-hospitalar (p = 0,11); Porta-agulha (p < 0,0001); Porta-balão (p < 0,0001); Tempo sintomas-reperfusão (p < 0,0001). As taxas de mortalidade hospitalar (4,3% versuss 9,2%, p = 0,0007) e mortalidade aos 6 meses (6,3% versus 13,8%, p < 0,0001) foram significativamente inferiores no GTG. Conclusões: O Projeto Algarve reduziu significativamente os tempos de demora entre o início dos sintomas e reperfusão, aumentou significativamente a taxa de reperfusão e diminuiu significativamente as taxas de mortalidade hospitalar e aos seis meses. Keywords: ST-elevation myocardial infarction, Treatment delays, Reperfusion therapy, Pre-hospital clinical network, Mortality, Palavras-chave: Enfarte agudo do miocárdio com elevação do segmento ST, Tempos de demora, Terapia de reperfusão, Rede pré-hospital, Mortalidadehttp://www.sciencedirect.com/science/article/pii/S0870255112000145 |