通过社交媒体激活心导管实验室可减少转到社区医院进行初级经皮冠状动脉介入治疗的患者再灌注时间

Guozhong Wang
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The primary endpoint was median first medical contact (FMC)-to-device (FMC2D) times. The secondary endpoint was door-to-device (D2D) times. Results: The baseline clinical data and angiographic features among the two groups were similar (all P > 0.05. There was no difference in the symptom onset-to-FMC time (median interquartile range [IQR] min, 100.00 [74.50–247.00] vs. 105.00 [70.00–180.00], P > 0.05) between the two groups. Compared to control group, CCL group had shortened FMC2D times (median IQR min, 95.00 [72.60–160.58] vs. 160.79 [124.72–205.50], P < 0.001) and shortened D2D time (median IQR min, 17.18 [13.77–21.15] vs. 49.27 [40.26–64.90], P < 0.001). Achievement of the FMC2D time goal of <120 min rose from 29.82% in the control group to 76.74% in the CCL group (P < 0.001). 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目的:本研究旨在评价社区医院转经急诊部(ED)行初级经皮冠状动脉介入治疗(PCI)时,微信激活心导管实验室(CCL)对st段抬高型心肌梗死(STEMI)患者延迟的影响。方法:这是一项回顾性的队列研究,研究对象是从社区医院转到陆河医院进行初级PCI治疗的STEMI患者。将患者分为两组:CCL组在社区医院通过微信传送心电图,由急救医疗服务(EMS)直接转至CCL (n = 43);对照组无心电图传递患者在CCL到达前经EMS转至ED (n = 57)。主要终点是首次医疗接触(FMC)到设备(FMC2D)时间的中位数。次要终点是门到设备(D2D)时间。结果:两组患者的基线临床资料和血管造影特征相似(P < 0.05)。两组患者症状发作至fmc时间(中位数四分位数范围[IQR] min, 100.00 [74.50-247.00] vs. 105.00 [70.00-180.00], P < 0.05)无差异。与对照组相比,CCL组FMC2D时间缩短(IQR min中位数,95.00[72.60-160.58]比160.79 [124.72-205.50],P < 0.001), D2D时间缩短(IQR min中位数,17.18[13.77-21.15]比49.27 [40.26-64.90],P < 0.001)。FMC2D时间目标<120 min的达成率从对照组的29.82%上升到CCL组的76.74% (P < 0.001)。结论:微信激活CCL可缩短社区医院转PCI STEMI患者再灌注时间。
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Cardiac catheterization laboratory activation by social media reduces reperfusion time of patients transferred for primary percutaneous coronary intervention in community hospital
Objective: The objective of the study is to evaluate the impact of cardiac catheterization laboratory (CCL) activation by WeChat in community hospitals transfer for primary percutaneous coronary intervention (PCI) bypassing emergency department (ED) on time delay in ST-segment elevation myocardial infarction (STEMI) patients. Methods: This was a retrospective, cohort study of STEMI patients who were transferred from community hospitals to Luhe Hospital for primary PCI. Patients were divided into two groups: in CCL group, electrocardiogram (ECG) was transmitted through WeChat in the community hospital and the patients were transferred directly to CCL by emergency medical services (EMS) (n = 43); in control group, patients without ECG transmission were transferred by EMS to ED before CCL arrival (n = 57). The primary endpoint was median first medical contact (FMC)-to-device (FMC2D) times. The secondary endpoint was door-to-device (D2D) times. Results: The baseline clinical data and angiographic features among the two groups were similar (all P > 0.05. There was no difference in the symptom onset-to-FMC time (median interquartile range [IQR] min, 100.00 [74.50–247.00] vs. 105.00 [70.00–180.00], P > 0.05) between the two groups. Compared to control group, CCL group had shortened FMC2D times (median IQR min, 95.00 [72.60–160.58] vs. 160.79 [124.72–205.50], P < 0.001) and shortened D2D time (median IQR min, 17.18 [13.77–21.15] vs. 49.27 [40.26–64.90], P < 0.001). Achievement of the FMC2D time goal of <120 min rose from 29.82% in the control group to 76.74% in the CCL group (P < 0.001). Conclusion: CCL activated by WeChat can reduce reperfusion time of STEMI patients who are transferred for PCI from community hospitals.
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