Early coronary angiography in NSTEMI: a regional Victorian perspective.

Background: Current guidelines highlight a paucity of evidence guiding optimal timing for non-ST-elevation myocardial infarction (NSTEMI) in high-risk and non-high-risk cases.

Aim: We assessed long-term major adverse cardiovascular events (MACEs) in NSTEMI patients undergoing early (<24 h) versus delayed (>24 h) coronary angiography at 6 years. Secondary end-points included all-cause mortality and cumulative MACE outcomes.

Pre-hospital 12 lead ECG to triage ST elevation myocardial infarction and long term improvements in door to balloon times: The first 1000 patients from the MonAMI project.

Background: Pre-hospital ECG is one strategy to improve door to balloon times (D2BT), however its long term effectiveness to sustain reductions in D2BT has not been evaluated.

Methods: From 2007 to 2011 we conducted a prospective interventional study involving 1000 patients undergoing primary PCI (PPCI) at a single tertiary referral institution to determine the long term impact of pre-hospital 12 lead ECG on D2BT.

Results: The median D2BT of patients (n=414) who underwent PPCI following field 12-lead ECG was 54 min [IQR: 37-71 min] compared to the median time of a contemporary group (n=586) undergoing PPCI during the same period but not presenting via field triage of 100 min [74-134] (p<0.

Guideline recommended door-to-balloon time can be achieved in transradial primary PCI--the usefulness of a dedicated radial guide catheter.

Background: Radial access for primary percutaneous coronary intervention (PPCI) is well established in terms of safety and efficacy. However, there are limited data on the impact of the use of a single dedicated radial guide catheter in primary PCI using radial access.

Aims: To determine the overall cardiac catheterisation laboratory to balloon time (CCL2BT) and door to balloon (D2BT) time in transradial PPCI.

Prehospital 12-lead ECG to triage ST-elevation myocardial infarction and emergency department activation of the infarct team significantly improves door-to-balloon times: ambulance Victoria and MonashHEART Acute Myocardial Infarction (MonAMI) 12-lead ECG project.

Background: American College of Cardiology/American Heart Association guidelines recommend >75% of patients with an ST-elevation myocardial infarction receive primary percutaneous coronary interventions (PPCI) within 90 minutes. Despite these recommendations, this goal has been difficult to achieve.

Methods And Results: We conducted a prospective interventional study involving 349 patients undergoing PPCI at a single tertiary referral institution to determine the impact of prehospital 12-lead ECG triage and emergency department activation of the infarct team on door-to-balloon time (D2BT).