The Busan Regional CardioCerebroVascular Center Project's Experience Over a Decade in the Treatment of ST-segment Elevation Myocardial Infarction

Kyung Hee Lim; Hyeyeon Moon; Jong Sung Park; Young-Rak Cho; Kyungil Park; Tae Ho Park; Moo Hyun Kim; Young-Dae Kim

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자료유형: 학술저널

저자정보: Kyung Hee Lim (Dong-A University Hospital) Hyeyeon Moon (Dong-A University Hospital) Jong Sung Park (Dong-A University Hospital) Young-Rak Cho (Dong-A University Hospital) Kyungil Park (Dong-A University Hospital) Tae Ho Park (Dong-A University Hospital) Moo Hyun Kim (Dong-A University Hospital) Young-Dae Kim (Dong-A University Hospital)

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제55권 제4호

발행연도: 2022.7

수록면: 351 - 359 (9page)

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Objectives: The Regional CardioCerebroVascular Center (RCCVC) project was initiated to improve clinical outcomes for patients with acute myocardial infarction or stroke in non-capital areas of Korea. The purpose of this study was to evaluate the outcomes and issues identified by the Busan RCCVC project in the treatment of ST-segment elevation myocardial infarction (STEMI). Methods: Among the patients who were registered in the Korean Registry of Acute Myocardial Infarction for the RCCVC project between 2007 and 2019, those who underwent percutaneous coronary intervention (PCI) for STEMI at the Busan RCCVC were selected, and their medical data were compared with a historical cohort. Results: In total, 1161 patients were selected for the analysis. Ten years after the implementation of the Busan RCCVC project, the median door-to-balloon time was reduced from 86 (interquartile range [IQR], 64-116) to 54 (IQR, 44-61) minutes, and the median symptom-to-balloon time was reduced from 256 (IQR, 180-407) to 189 (IQR, 118-305) minutes (p<0.001). Inversely, the false-positive PCI team activation rate increased from 0.6% to 21.4% (p<0.001). However, the 1-year cardiovascular death and major adverse cardiac event rates did not change. Even after 10 years, approximately 75% of the patients had a symptom-to-balloon time over 120 minutes, and approximately 50% of the patients underwent inter-hospital transfer for primary PCI. Conclusions: A decade after the implementation of the Busan RCCVC project, although time parameters for early reperfusion therapy for STEMI improved, at the cost of an increased false-positive PCI team activation rate, survival outcomes were unchanged.

#Acute myocardial infarction #Percutaneous coronary intervention #Korea

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