{"id":11876,"date":"2011-09-20T08:30:50","date_gmt":"2011-09-20T12:30:50","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=11876"},"modified":"2011-09-20T08:59:12","modified_gmt":"2011-09-20T12:59:12","slug":"slow-spots-in-transfer-of-primary-pci-patients","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2011\/09\/20\/slow-spots-in-transfer-of-primary-pci-patients\/","title":{"rendered":"Slow Spots in Transfer of Primary PCI Patients"},"content":{"rendered":"<p>In recent years\u00a0<a title=\"Door-to-Balloon Time Closes In On 1 Hour\" href=\"http:\/\/blogs.nejm.org\/cardioexchange\/news\/door-to-balloon-time-closes-in-on-1-hour\/\">great progress has been made<\/a>\u00a0in speeding the delivery of primary PCI to STEMI patients, but lingering problems remain, especially involving the transfer of patients from centers without primary PCI capability. <a href=\"http:\/\/circ.ahajournals.org\/content\/early\/2011\/09\/19\/CIRCULATIONAHA.111.033118.abstract\">A new study published in\u00a0<\/a><em><a href=\"http:\/\/circ.ahajournals.org\/content\/early\/2011\/09\/19\/CIRCULATIONAHA.111.033118.abstract\">Circulation<\/a>\u00a0<\/em>helps to identify the precise causes for delays with these patients.<\/p>\n<p>Michael\u00a0Miedema\u00a0and colleagues analyzed data from 2034 patients transferred to the Minneapolis Heart Institute\u00a0from March 2003 to December 2009. Some 30.4% of patients received treatment within 90 minutes and 65.7% within 2 hours.<\/p>\n<p>Of the patients, 64.0% experienced delays at the referral hospital. Other major occasions of delay were at the primary PCI center (15.7% of patients) and during transfer (12.6% of patients). Delays were most frequently caused by lack of transportation (26.4%) and delays in the ED (14.3%). The longest mean delays were caused by diagnostic dilemmas (95.5 minutes) and nondiagnostic\u00a0initial ECGs (81 minutes).<\/p>\n<p>In their discussion, the researchers point out that &#8220;the cause of the delay may be more important than the actual length of delay&#8221; and emphasize that &#8220;clinical outcomes vary significantly according to the reason for the delay, and that not all delays are STEMI system dependent.&#8221; Most cases of cardiogenic shock or cardiac arrest, for instance, are not a result of a delay but more likely are the cause of a delay, they write.\u00a0In a press release from the AHA, senior study author Timothy Henry points out that\u00a0higher-risk patients have the worst outcome and that this phenomenon is related to their advanced disease state and may not be related to a delay in treatment.<\/p>\n<p>The authors write that their study supports a goal for total door-to-balloon time of 120 minutes for transferred STEMI patients.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A new study in Circulation helps identify the precise causes for delays that occur when STEMI patients are transferred for primary PCI.<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[531,874,302,257,983],"class_list":["post-11876","post","type-post","status-publish","format-standard","hentry","category-interventional-cardiology","tag-delays","tag-hospital-delays","tag-primary-pci","tag-stemi","tag-transfer"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/11876","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=11876"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/11876\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=11876"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=11876"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=11876"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}