Prehospital Activation of the Catheterization Laboratory Among Patients With Suspected ST-Elevation Myocardial Infarction Outside of a Hospital ― Systematic Review and Meta-Analysis ―
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- Hashiba Katsutaka
- Department of Cardiology, Saiseikai Yokohama-shi Nanbu Hospital
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- Nakashima Takahiro
- Department of Emergency Medicine, University of Michigan
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- Kikuchi Migaku
- Department of Cardiovascular Medicine, Emergency and Critical Care Center, Dokkyo Medical University
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- Kojima Sunao
- Department of Internal Medicine, Sakurajyuji Yatsushiro Rehabilitation Hospital
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- Hanada Hiroyuki
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Mano Toshiaki
- Kansai Rosai Hospital Cardiovascular Center
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- Yamamoto Takeshi
- Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
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- Tanaka Akihito
- Department of Cardiology, Nagoya University Graduate School of Medicine
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- Yamaguchi Junichi
- Department of Cardiology, Tokyo Women’s Medical University
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- Matsuo Kunihiro
- Department of Acute Care Medicine, Fukuoka University Chikushi Hospital
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- Nakayama Naoki
- Department of Cardiology, Kanagawa Cardiovascular and Respiratory Center
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- Nomura Osamu
- Department of Emergency and Disaster Medicine, Hirosaki University
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- Matoba Tetsuya
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medical Sciences
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- Tahara Yoshio
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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- Nonogi Hiroshi
- Faculty of Health Science, Osaka Aoyama University
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説明
<p>Background: In the management of patients with ST-elevation myocardial infarction (STEMI), system delays for reperfusion therapy are still a matter of concern. We investigated the impact of prehospital activation of the catheterization laboratory in the management of STEMI patients.</p><p>Methods and Results: This is a systematic review of observational studies. A search was conducted of the PubMed database from inception to July 2020 to identify articles for inclusion in the study. The critical outcomes were short- and long-term mortality. The important outcome was door-to-balloon time. The GRADE approach was used to assess the certainty of the evidence. Seven studies assessed short-term mortality; 1,541 were assigned to the prehospital activation (PH) group and 1,191 were assigned to the emergency department activation (ED) group. There were 26 fewer deaths per 1,000 patients in the PH group. Three studies assessed long-term mortality; 713 patients were assigned to the PH group and 1,026 were assigned to the ED group. There were 54 fewer deaths per 1,000 patients among the PH group. Five studies assessed door-to-balloon time; 959 were assigned to the PH group and 631 to the ED group. Door-to-balloon time was 33.1 min shorter in the PH group.</p><p>Conclusions: Prehospital activation of the catheterization laboratory resulted in lower mortality and shorter door-to-balloon time for patients with suspected STEMI outside of a hospital.</p>
収録刊行物
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- Circulation Reports
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Circulation Reports 4 (9), 393-398, 2022-09-09
一般社団法人 日本循環器学会
