Assessment of the Diagnosis-To-Needle Times for Patients Admitted to the Emergency Department with Acute ST-Segment Elevation Myocardial Infarction
Article Category: Original Research
Pubblicato online: 21 mar 2024
Pagine: 20 - 26
Ricevuto: 20 dic 2023
Accettato: 08 mar 2024
DOI: https://doi.org/10.2478/jce-2024-0009
Parole chiave
© 2024 Enes Çon et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Background
Coronary artery disease is one of the most common causes of death in the world. The outcome of patients with ST-elevation myocardial infarction is influenced by many factors, and the time elapsed from symptom onset to diagnosis and reperfusion have a critical role in this regard.
Aim
The aim of this study was to investigate the differences in the diagnosis-to-needle times of patients with STEMI presenting to the hospital during and outside of working hours, and the effect of this relationship on in-hospital clinical events.
Methods
This retrospective study analyzed the data of 50 patients admitted for emergency primary percutaneous coronary intervention. We assessed pain onset-to-diagnosis times and diagnosis-to-needle times, and evaluated their relationship with troponin values at admission and after 48 h.
Results
The mean age of the patients was 55.64 ± 13.72 years. In total, 60% of the patients presented outside of working hours. Mean patient delay time from the onset of chest pain to seeking medical help was 2.64 ± 2.47 h. Mean troponin values were 4.39 ± 5.26 ng/ml at admission and 36.50 ± 12.95 ng/ml after 48 h. Mean post-angiography ejection fraction values were 47.36 ± 6.53%. We found a statistically significant difference in the pain onset-to-diagnosis and diagnosis-to-needle times of patients who presented to the hospital during and outside of working hours. We found a positive correlation between diagnosis-to-needle times and the troponin values of patients, and a statistically significant difference between pain onset-to-diagnosis times of patients who presented during and outside of working hours (p < 0.05). Although the relationship between the diagnosis-to-needle time and troponin elevation after 48 h was strong (97%), the relationship between pain onset-to-diagnosis time and troponin elevation after 48 h was weak (8%), suggesting that the duration of surgical intervention is much more important than the time until the first medical contact.
Conclusions
In this study, there was a statistically significant difference in the pain onset-to-diagnosis and diagnosis-to-needle times of patients who presented to the hospital during and outside of working hours.