PROCESS TIMES IN PRIMARY PERCUTANEOUS CORONARY INTERVENTION: WHERE DOES THE TIME GO?

Abstract

ST-elevation myocardial infarction (STEMI) is a medical emergency and the treatment of choice, if available in a timely manner, is primary percutaneous coronary intervention (PPCI). It is in the best interest of the patient to receive this treatment as soon as possible to reduce ischemic injury to the heart. Using routinely recorded data from the Nova Scotia Health Authority on patients who receive PPCI between 2012-2014 we determined which components of the process contributed the most to total ischemic time. We determined that the majority of time and variation seen in total ischemic time was before the patient arrives at the hospital. Very little variation in process times were found once the patient arrives at the hospital. We also determined that sex is associated with longer total ischemic times after adjustment for cardiac history and process variables. The emphasis of future research should be reducing patients’ decision time to seek medical care for acute coronary syndrome as hospital delay in our system was found to be minimal when considering the larger picture.