Statistical analysis was performed using SAS version 9.1 (SAS Institute Inc, Cary, NC). Normally distributed continuous variables are presented as mean ± SD. Those variables not normally distributed are shown as median ± interquartile range. Categorical variables are expressed as frequencies and percentages. Baseline characteristics were compared using Student’s t test for parametric variables or the Mann–Whitney U test when not normally distributed.
Categorical variables were compared using chi-square test or Fisher’s exact test as appropriate. From 03/2011 to 03/2012, there were a total of 470 STEMI system activations; CHap was used in 83 cases (17.7%). (Fig. 3) In the overall population of STEMI cases, the mean age was 61 years. The majority was male (69.6%) and Caucasian (52%), with 43.8% being African-American. Baseline demographic and clinical characteristics of EPZ-6438 supplier STEMI patients who underwent PCI in which CHap was used were GSK2118436 comparable to those treated via standard channels of activation. (Table 1) Likewise, baseline and angiographic procedural characteristics between groups were very similar. (Table 2) Of note, non-significant trends toward higher incidences of diabetes mellitus
and a higher number of lesions treated were present in patients managed via standard channels of activation. In-hospital outcomes are presented in Table 3. None of the evaluated end points differed significantly between groups. An unfavorable trend toward higher in-hospital MACE was present for patients
managed via standard channels of activation, contributed by cardiac death, urgent TLR, and the need for coronary artery bypass surgery (Table 3). Quality measures evaluating the STEMI system of care are presented in Table 4. When the CHap was utilized to activate the management flow of a possible STEMI case, a significantly shorter DTB time was achieved (CHap 103 minutes, 95% CI [87.0–118.3] vs. standard 149 minutes, 95% CI [134.0–164.8], either p < 0.0001). Similarly, call-to-lab and call-to-balloon were significantly shortened (CHap 33 minutes, 95% CI [26.2–40.1] vs. standard 56 minutes, 95% CI [49.9–61.3], p < 0.0001) and (CHap 70 minutes, 95% CI [60.8–79.5] vs. standard 92 minutes, 95% CI [85.8–98.9], p = 0.0002), respectively. Notably, all parameters evaluating management before the initial call (door-to-EKG, door-to-call and EKG-to-call) were similar between the two cohorts. Likewise, all parameters evaluating management after arrival at the receiving hospital (lab-to-balloon, lab-to-case start, and case start-to-balloon) did not differ between the two routes used to activate the system of STEMI care. Table 5 describes the rate of ‘true positive’ activations in each study arm as a comparative measure of triage effectiveness. From the 470 STEMI system activations, CHap was used in 83 cases (17.7%), compared to standard channels used in 387 cases (82.3%). (Fig.