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Pre-hospital alarm activation for STEMI patients undergoing primary percutaneous coronary intervention in the era of transradial procedures

      Highlights

      • Pre-hospital alarm system improves clinical outcome at 1-year follow-up.
      • Pre-hospital alarm reduces the time to treatment in patients with STEMI.
      • Pre-hospital alarm is beneficial in a cohort of patients mainly treated with TRA.

      Abstract

      Background

      Transradial access (TRA) improves outcome compared with trans-femoral access for the management of patients with acute coronary syndromes. In this setting, it is unknown whether the activation of a pre-hospital alarm system (PHAS) confers additional benefit for the prognosis of patients with ST-segment elevation myocardial infarction (STEMI).

      Materials and methods

      We retrospectively analyzed a cohort of patients with a first STEMI who underwent a primary percutaneous coronary intervention (PPCI) at a single center within a prospective cohort of acute coronary syndrome patients (SPUM-ACS). TRA was used in 85% of patients. We assessed how PHAS (n = 165) vs. no-PHAS (n = 166) activation was associated with the composite outcome of all-cause mortality and recurrence of myocardial infarction (MI) at 1-year follow-up. As secondary outcomes, the individual clinical endpoints were separately assessed for association.

      Results

      Compared with no-PHAS patients, patients in the PHAS group were predominantly women, and presented more frequently with dyslipidemia and cardiac arrest. A significant reduction in the composite outcome of all-cause mortality and recurrent MI at 1-year was observed in the PHAS group, compared with no-PHAS (3.6% vs. 8.5%, p = 0.027). When adjusted for age, sex and resuscitation status, PHAS activation remained associated with decreased all-cause mortality and recurrent MI (HR: 0.36 [95% CI: 0.13–0.95]; p = 0.040).

      Conclusions

      This study suggests that the benefit of PHAS activation in STEMI patients undergoing PPCI persists also in the era of TRA.

      Keywords

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