A comparison of the pre-hospital 12-lead electrocardiogram transmission protocol and the pre-hospital ambulance notification protocol for patients with acute myocardial infarction.

BACKGROUND

Whether the pre-hospital 12-lead electrocardiogram transmission (ph12ET) protocol is more effective than the pre-hospital ambulance notification protocol (phAN) for managing patients with acute myocardial infarction (AMI) is unclear.

METHODS AND

RESULTS

We evaluated patients with AMI from the Mie Acute Coronary Syndrome (ACS) Registry who were transported by emergency medical services between January 2013 and December 2019. Patients were divided into four groups depending on whether they received ph12ET or phAN and whether they had ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). A total of 1931 of the 4504 patients (42.9 %) were enrolled, including 375 (19.4 %) who were residents of Tsu City, which performs ph12ET. All patients underwent primary percutaneous coronary intervention. Among STEMI patients, the median door-to-balloon time (63 min vs. 80 min) was significantly shorter (p < 0.01) and the achievement ratios of door-to-balloon times <90 min (77.1 % vs. 63.7 %) significantly higher (p < 0.01) in the ph12ET group than in the phAN group. All-cause 1-year mortality of NSTEMI with phAN was higher than that of the other groups according to Kaplan-Meier curves (p = 0.032).

CONCLUSION

The reperfusion time in patients with STEMI with ph12ET was shorter than that in those with phAN. Furthermore, the prognosis of NSTEMI is better with ph12ET than with phAN.