On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital

Detalhes bibliográficos
Autor(a) principal: Pinheiro Machado, Guilherme
Data de Publicação: 2018
Outros Autores: Neves de Araujo, Gustavo, Mariani, Stefani, Pellin Cassol, Elvis, Homem Valle, Felipe, Maria Krepsky, Ana, Carlos Corsetti Bergoli, Luiz, Cadaval Gonçalves, Sandro, Wainstein, Rodrigo, Wainstein, Marco
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinical and Biomedical Research
Texto Completo: https://seer.ufrgs.br/index.php/hcpa/article/view/75542
Resumo: Introduction: Early reperfusion therapy is crucial in patients with ST-elevation myocardial infarction (STEMI). Off-hours hospital presentation may increase the time from pain to coronary reperfusion, and it may be responsible for increased cardiovascular outcomes. The aim of this study was to compare the effect of different times of presentation (on- and off-hours) on early mortality and major cardiovascular outcomes in patients with STEMI who underwent primary percutaneous coronary intervention (PCI).Methods: We have included consecutive patients with STEMI who underwent primary PCI between April 2011 and November 2016 in a tertiary university hospital in southern Brazil. Patients were divided into on- and off-hours admission. In-hospital and 30-day outcomes were evaluated.Results: A total of 301 patients (57.4%) were admitted during off-hours, and 223 (42.5%) during on-hours. Baseline characteristics were well balanced between the two groups. Median door-to-balloon time was higher in the off-hours group than in the on-hours group: 75 min (IQR 60-95) vs. 60 min (IQR 50-73.7) respectively (p < 0.001). In-hospital mortality was similar between groups (odds ratio [OR] = 0.56; 95% confidence interval [95%CI] 0.31-1.03; p = 0.06) and at 30-day follow-up (OR = 0.2; 95%CI 0.02-1.72 p = 0.14). In the matched cohort, no difference was found in the rates of in-hospital mortality (OR = 2.0; 95%CI 0.75-5.32; p = 0.16) and 30-day MACE (OR= 0.9; 95%CI 0.49-1.66; p = 0.75).Conclusions: In our center with PCI available 24/7 – without in-house staff – we did not observe any difference in patient characteristics, management, and outcomes, although a significant longer door-to-balloon time was found in patients treated during night shifts. Our results are consistent with those of other trials.Keywords: Myocardial infarction; percutaneous coronary intervention; system delay
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spelling On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospitalMyocardial infarctionpercutaneous coronary interventionsystem delayIntroduction: Early reperfusion therapy is crucial in patients with ST-elevation myocardial infarction (STEMI). Off-hours hospital presentation may increase the time from pain to coronary reperfusion, and it may be responsible for increased cardiovascular outcomes. The aim of this study was to compare the effect of different times of presentation (on- and off-hours) on early mortality and major cardiovascular outcomes in patients with STEMI who underwent primary percutaneous coronary intervention (PCI).Methods: We have included consecutive patients with STEMI who underwent primary PCI between April 2011 and November 2016 in a tertiary university hospital in southern Brazil. Patients were divided into on- and off-hours admission. In-hospital and 30-day outcomes were evaluated.Results: A total of 301 patients (57.4%) were admitted during off-hours, and 223 (42.5%) during on-hours. Baseline characteristics were well balanced between the two groups. Median door-to-balloon time was higher in the off-hours group than in the on-hours group: 75 min (IQR 60-95) vs. 60 min (IQR 50-73.7) respectively (p < 0.001). In-hospital mortality was similar between groups (odds ratio [OR] = 0.56; 95% confidence interval [95%CI] 0.31-1.03; p = 0.06) and at 30-day follow-up (OR = 0.2; 95%CI 0.02-1.72 p = 0.14). In the matched cohort, no difference was found in the rates of in-hospital mortality (OR = 2.0; 95%CI 0.75-5.32; p = 0.16) and 30-day MACE (OR= 0.9; 95%CI 0.49-1.66; p = 0.75).Conclusions: In our center with PCI available 24/7 – without in-house staff – we did not observe any difference in patient characteristics, management, and outcomes, although a significant longer door-to-balloon time was found in patients treated during night shifts. Our results are consistent with those of other trials.Keywords: Myocardial infarction; percutaneous coronary intervention; system delayHCPA/FAMED/UFRGS2018-04-11info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed ArticleAvaliado por Paresapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/75542Clinical & Biomedical Research; Vol. 38 No. 1 (2018): Clinical and Biomedical ResearchClinical and Biomedical Research; v. 38 n. 1 (2018): Clinical and Biomedical Research2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSenghttps://seer.ufrgs.br/index.php/hcpa/article/view/75542/pdfCopyright (c) 2018 Clinical and Biomedical Researchinfo:eu-repo/semantics/openAccessPinheiro Machado, GuilhermeNeves de Araujo, GustavoMariani, StefaniPellin Cassol, ElvisHomem Valle, FelipeMaria Krepsky, AnaCarlos Corsetti Bergoli, LuizCadaval Gonçalves, SandroWainstein, RodrigoWainstein, Marco2024-01-19T14:23:13Zoai:seer.ufrgs.br:article/75542Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2024-01-19T14:23:13Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.none.fl_str_mv On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
title On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
spellingShingle On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
Pinheiro Machado, Guilherme
Myocardial infarction
percutaneous coronary intervention
system delay
title_short On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
title_full On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
title_fullStr On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
title_full_unstemmed On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
title_sort On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
author Pinheiro Machado, Guilherme
author_facet Pinheiro Machado, Guilherme
Neves de Araujo, Gustavo
Mariani, Stefani
Pellin Cassol, Elvis
Homem Valle, Felipe
Maria Krepsky, Ana
Carlos Corsetti Bergoli, Luiz
Cadaval Gonçalves, Sandro
Wainstein, Rodrigo
Wainstein, Marco
author_role author
author2 Neves de Araujo, Gustavo
Mariani, Stefani
Pellin Cassol, Elvis
Homem Valle, Felipe
Maria Krepsky, Ana
Carlos Corsetti Bergoli, Luiz
Cadaval Gonçalves, Sandro
Wainstein, Rodrigo
Wainstein, Marco
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Pinheiro Machado, Guilherme
Neves de Araujo, Gustavo
Mariani, Stefani
Pellin Cassol, Elvis
Homem Valle, Felipe
Maria Krepsky, Ana
Carlos Corsetti Bergoli, Luiz
Cadaval Gonçalves, Sandro
Wainstein, Rodrigo
Wainstein, Marco
dc.subject.por.fl_str_mv Myocardial infarction
percutaneous coronary intervention
system delay
topic Myocardial infarction
percutaneous coronary intervention
system delay
description Introduction: Early reperfusion therapy is crucial in patients with ST-elevation myocardial infarction (STEMI). Off-hours hospital presentation may increase the time from pain to coronary reperfusion, and it may be responsible for increased cardiovascular outcomes. The aim of this study was to compare the effect of different times of presentation (on- and off-hours) on early mortality and major cardiovascular outcomes in patients with STEMI who underwent primary percutaneous coronary intervention (PCI).Methods: We have included consecutive patients with STEMI who underwent primary PCI between April 2011 and November 2016 in a tertiary university hospital in southern Brazil. Patients were divided into on- and off-hours admission. In-hospital and 30-day outcomes were evaluated.Results: A total of 301 patients (57.4%) were admitted during off-hours, and 223 (42.5%) during on-hours. Baseline characteristics were well balanced between the two groups. Median door-to-balloon time was higher in the off-hours group than in the on-hours group: 75 min (IQR 60-95) vs. 60 min (IQR 50-73.7) respectively (p < 0.001). In-hospital mortality was similar between groups (odds ratio [OR] = 0.56; 95% confidence interval [95%CI] 0.31-1.03; p = 0.06) and at 30-day follow-up (OR = 0.2; 95%CI 0.02-1.72 p = 0.14). In the matched cohort, no difference was found in the rates of in-hospital mortality (OR = 2.0; 95%CI 0.75-5.32; p = 0.16) and 30-day MACE (OR= 0.9; 95%CI 0.49-1.66; p = 0.75).Conclusions: In our center with PCI available 24/7 – without in-house staff – we did not observe any difference in patient characteristics, management, and outcomes, although a significant longer door-to-balloon time was found in patients treated during night shifts. Our results are consistent with those of other trials.Keywords: Myocardial infarction; percutaneous coronary intervention; system delay
publishDate 2018
dc.date.none.fl_str_mv 2018-04-11
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
Avaliado por Pares
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/75542
url https://seer.ufrgs.br/index.php/hcpa/article/view/75542
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/75542/pdf
dc.rights.driver.fl_str_mv Copyright (c) 2018 Clinical and Biomedical Research
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2018 Clinical and Biomedical Research
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv HCPA/FAMED/UFRGS
publisher.none.fl_str_mv HCPA/FAMED/UFRGS
dc.source.none.fl_str_mv Clinical & Biomedical Research; Vol. 38 No. 1 (2018): Clinical and Biomedical Research
Clinical and Biomedical Research; v. 38 n. 1 (2018): Clinical and Biomedical Research
2357-9730
reponame:Clinical and Biomedical Research
instname:Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
instname_str Universidade Federal do Rio Grande do Sul (UFRGS)
instacron_str UFRGS
institution UFRGS
reponame_str Clinical and Biomedical Research
collection Clinical and Biomedical Research
repository.name.fl_str_mv Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)
repository.mail.fl_str_mv ||cbr@hcpa.edu.br
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