Effect of STEMI from Home System Usage

Abstract

Background: To date, evidence of pre-hospital electrocardiography (ECG) in STEMI patient in Thailand are lacking. Objectives: To study the clinical outcomes in STEMI from home system compared with old STEMI system. Methods: This prospective quasi-experimental study included in STEMI patients living in Mueang Chaing Rai who used the emergency medical system during October 2021 to September 2024. Primary outcome was a first medical contact (FMC) to balloon time. Secondary outcomes were other STEMI-related times and in-hospital mortality. The statistical analysis was used mean, standard deviation, chi-square test, student t-test and binary logistic regression. The risk results were showed as odds ratio, 95% confidence interval (CI) and statistically significant level p < .05. Results: A total of 36 patients were included in this study. There were 9 patients in STEMI from home system and 27 patients in old STEMI system. Most patients were male. An average age was 63.4 years old. Baseline characteristics were similar between 2 groups. The FMC to balloon time was 79.8 minutes in STEMI from home group and 124.2 minutes in old STEMI group (absolute difference 44.4 minutes; 95%CI: 12.5, 76.4; p < .01). The FMC to ECG time was 3.9 minutes in STEMI from home group and 37.8 minutes in old STEMI group (absolute difference 33.4 minutes; 95%CI: 19.8, 47.0; p < .01). The FMC to consult time was 13.0 minutes in STEMI from home group and 50.9 minutes in old STEMI group (absolute difference 37.9 minutes; 95%CI: 20.8, 55.0; p < .01). The in-hospital mortality was similar between 2 groups (0% and 14.8%; p = .30). Conclusions: Using STEMI from home system made STEMI patients faster done 12-lead ECG, faster diagnosed, and consulted cardiologist which the STEMI primary PCI protocol can activate at patient’s home or during referral, faster revascularization by primary PCI and trend to decrease in-hospital mortality.