Author + information
- Received April 8, 2010
- Revision received October 28, 2010
- Accepted November 15, 2010
- Published online February 1, 2011.
- Monica Sanchez-Ross, MD⁎,
- Gerard Oghlakian, MD⁎,
- James Maher, MD⁎,
- Brijesh Patel, MD⁎,
- Victor Mazza, MD⁎,
- David Hom, MS†,
- Vivek Dhruva, DO‡,
- David Langley, MICP§,
- Jack Palmaro, MA, MPH⁎,
- Sultan Ahmed, MD⁎,
- Edo Kaluski, MD⁎ and
- Marc Klapholz, MD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Marc Klapholz, Division of Cardiovascular Diseases, Department of Medicine, New Jersey Medical School/University of Medicine and Dentistry of New Jersey, 185 South Orange Avenue MSB I-530, Newark, New Jersey 07103
Objectives The goal of this study was to evaluate the impact of the STAT-MI (ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction) network on outcomes in the treatment of patients presenting with ST-segment elevation myocardial infarction (STEMI).
Background Shortening door-to-balloon (D2B) time remains a national priority for the treatment of STEMI. We previously reported a fully automated wireless network (STAT-MI) for transmission of electrocardiograms (ECGs) for suspected STEMI from the field to offsite cardiologists, allowing early triage with shortening of subsequent D2B times. We now report the impact of the STAT-MI wireless network on infarct size, length of hospital stay (LOS), and mortality.
Methods A fully automated wireless network (STAT-MI) was developed to enable automatic 12-lead ECG transmission and direct communication between emergency medical services personnel and offsite cardiologists that facilitated direct triage of patients to the cardiac catheterization laboratory. Demographic, laboratory, and time interval data of STAT-MI network patients were prospectively collected over a 33-month period and compared with concurrent control patients who presented with STEMI through non–STAT-MI pathways.
Results From June 2006 through February 2009, 92 patients presented via the STAT-MI network, and 50 patients presented through non–STAT-MI pathways (control group). Baseline clinical and demographic variables were similar in both groups. Overall, compared with control subjects, STAT-MI patients had significantly shorter D2B times (63 [42 to 87] min vs. 119 [96 to 178] min, U = 779.5, p < 0.00004), significantly lower peak troponin I (39.5 [11 to 120.5] ng/ml vs. 87.6 [38.4 to 227] ng/ml, U = 889.5, p = 0.005) and creatine phosphokinase-MB (126.1 [37.2 to 280.5] ng/ml vs. 290.3 [102.4 to 484] ng/ml, U = 883, p = 0.001), higher left ventricular ejection fractions (50% [35 to 55] vs. 35% [25 to 52], U = 1,075, p = 0.004), and shorter LOS (3 [2 to 4] days vs. 5.5 [3.5 to 10.5] days, U = 378, p < 0.001).
Conclusions A fully automated, field-based, wireless network that transmits ECGs automatically to offsite cardiologists for the early evaluation and triage of patients with STEMI shortens D2B times, reduces infarct size, limits ejection fraction reduction, and shortens LOS.
All authors have reported that they have no relationships to disclose.
- Received April 8, 2010.
- Revision received October 28, 2010.
- Accepted November 15, 2010.
- American College of Cardiology Foundation