Effectiveness and Clinical Outcome of Acute Myocardial Infarction Fast Tract: Emergency Department, Ramathibodi Hospital
Keywords:
Acute myocardial infarctionAbstract
Purpose & Method: Time is crucial for acute coronary syndrome (ACS) patients which is the main purpose of Acute Myocardial Infarction (AMI) fast tract development for early diagnosis and reperfusion therapy at Ramathibodi Hospital since 2010.Thus, using a retrospective chart review approach of patients who had been participated in AMI fast tract in emergency department at Ramathibodi Hospital during 2012 – 2014. this study aimed to evaluate the performance on ACS treatment based on international standards.
Result: 811 from 2000 patients with ischemic-like symptom who enrolled AMI fast tract had chest pain cause by non-cardiac cause (eg. gastroesophageal reflux disease, muscle strain) (n = 255, 31.44%), followed by non –ST-segment elevation myocardial infarction (NSTEMI) (n = 147, 18.1%), unstable angina (n = 112, 13.8.5%), Stable angina (n = 83, 10.2%), and ST-segment elevation myocardial infarction STEMI (n = 58, 7.15%). In this studied group, 88.5% who had performed ECG within 10 minutes had the annually average door-to-ECG time decreased to 17 (16), 6 (
7) and 5 (
0.06) minutes from 2012 to 2014, respectively. For STEMI patients, 88.5% (n = 50) received primary percutaneous intervention (PCI) for reperfusion therapy which 71.92% (n = 41) was performed within 90 minutes. The average door-to-balloon time was reduced from 95.01 (
41.79) minutes in 2013 to 83.58 (
37.19) minutes in 2014.
Conclusion: AMI fast tract is very effective based on American College of Cardiology/American Heart Association (ACC/AHA) and European Society of Cardiology (ESC).
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Copyright (c) 2016 By the authors. Licensee RMJ, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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