ECG Transmittal to Phone Reduces Door-to-PCI Time
Quantification of ST-segment depression does not additionally stratify risk
FRIDAY, March 28 (HealthDay News) -- Transmitting a prehospital electrocardiogram (ECG) directly to the attending cardiologist's mobile phone reduces the door-to-percutaneous coronary intervention (PCI) time by about an hour in patients with ST-segment elevation acute myocardial infarction, according to a report in the April 1 issue of the American Journal of Cardiology. A related study in the same issue showed that quantification of ST-segment depression does not provide additional risk stratification in patients with non-ST elevation acute coronary syndromes.
In the first study, Maria Sejersten, M.D., from Copenhagen University Hospital Rigshospitalet in Denmark, and colleagues examined whether transmitting a prehospital ECG directly to the attending cardiologist's mobile telephone could reduce the time to treatment in patients with ST-segment elevation acute myocardial infarction. Of 565 patients, 168 were referred for PCI after ECG evaluation and 146 underwent emergent catheterization. The researchers found that the median time from 911 call to PCI was significantly shorter (74 versus 127 minutes) and the median door-to-PCI time was also significantly shorter (34 versus 97 minutes).
In the second study, Raymond T. Yan, M.D., from the University of Toronto in Ontario, Canada, and colleagues examined the risk of in-hospital and cumulative mortality in 5,064 patients with non-ST elevation acute coronary syndromes based on quantitative ST-segment depression (present in 45 percent of patients). They found that quantification of ST-segment depression did not provide additional risk stratification beyond assessing its presence.
"This study demonstrates that compared with the well-established and prognostically robust qualitative evaluation of ST-segment depression, quantitative assessment does not improve the risk stratification of non-ST elevation acute coronary syndromes afforded by the registry-derived Global Registry of Acute Coronary Events (GRACE) risk models," Yan and colleagues write.