FRIDAY, Dec. 30 (HealthDay News) -- Fewer than half of patients admitted with acute ST-segment elevation myocardial infarction (STEMI) receive the timely reperfusion they need to improve their survival, according to a study in the January issue of the Journal of the American College of Cardiology.
Robert L. McNamara, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues analyzed door-to-needle and door-to-balloon times in patients admitted with STEMI between 1999 and 2002. Some 68,439 of the patients in 1,015 hospitals received fibrinolytic therapy, and 33,647 in 421 hospitals received percutaneous coronary intervention within six hours of their hospital arrival.
The researchers report that in 1999, only 46% of the patients getting fibrinolytic therapy were treated within the recommended 30-minute door-to-needle time, and only 35% of the patients in the percutaneous coronary intervention group were treated within the recommended 90-minute door-to-balloon time. The investigators found no statistically significant improvement in the time to reperfusion during the four-year study period.
"Fewer than one-half of patients with STEMI receive reperfusion in the recommended door-to-needle or door-to-balloon time, and mean time to reperfusion has not decreased significantly in recent years," the authors write. "Relatively few hospitals have shown substantial improvement."
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