Background: Conflicting data exist regarding the outcomes of primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) based on intervention timings. It is believed that short staffing at night hours may lead to a lapse in the delivery of effective, efficient and timely medical intervention.
Methods: A retrospective single-center study was performed, and a total of 436 patients were randomized into two groups. Group A had 279 patients who had the heart catheterization done during the daytime (between 6 am and 6 pm), while group B had 157 patients who had the same intervention performed at night (between 6 pm and 6 am).
Results: Door to balloon (DTB) time during the day was about 16 min shorter than the DTB time at night (81.29 ± 3.26 vs. 97.30 ± 8.54) with no statistical difference (P = 0.051). The mean troponin rise during the day was 1.94 ± 10.60 SEM (95% confidence interval (CI): -22.70 to 18.90) higher than night troponin levels (71.75 ± 7.18 vs. 69.80 ± 7.18), but P value was 0.85. The left ventricular ejection fraction (LVEF) fall for daytime was 0.93% vs. 0.90% for night time patients (P = 0.94).
Conclusion: There is no significant difference in the mean DTB time, the rise in troponin, fall in LVEF, readmission rates, or mortality, and hence no negative effects on patient outcomes based on the patient's time of presentation between the two groups.
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http://dx.doi.org/10.14740/cr862 | DOI Listing |
J Family Med Prim Care
December 2024
Department of Medicine, Universiti Teknologi MARA, Puncak Alam, Malaysia, Asia.
Unlabelled: Tuberculosis (TB) can affect any organ, and at times more than one organ in any sequence, in which case it is referred to as disseminated tuberculosis (DTB). We report a patient who presented primarily for psychiatric symptoms of three months' duration, which later turned out to be a case of DTB involving the central nervous system as well as the spine and lungs.
Case Presentation: An elderly lady with subacute onset and worsening behavioural changes of three months' duration was referred for exclusion of organic brain disease.
Cureus
November 2024
Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, USA.
Background Rapid treatment of ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) significantly reduces morbidity and mortality rates. Recent studies emphasize the importance of reducing total ischemic time, making first-medical-contact-to-balloon (FMCTB) time a key performance indicator. To improve FMCTB times in patients brought to the Emergency Department (ED) by Emergency Medical Services (EMS), we implemented a "Direct to Lab" (DTL) workflow during the following conditions: weekday daytime hours, when the lab is fully staffed, and for hemodynamically stable STEMI patients presenting via EMS.
View Article and Find Full Text PDFPanminerva Med
December 2024
Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy.
Background: Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics.
View Article and Find Full Text PDFPlant Cell Environ
February 2025
Department of Forest Mycology and Plant Pathology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Diplodia sapinea causes Diplodia tip blight (DTB) and is recognised as an opportunistic necrotrophic pathogen affecting conifers. While DTB is associated with abiotic stress, the impact of biotic stress in the host on D. sapinea's lifestyle shift is unknown.
View Article and Find Full Text PDFAm J Transl Res
July 2024
Department of Cardiology, Union Hospital Tongji Medical College, Huazhong University of Science and Technology Wuhan 430000, Hubei, China.
Objective: To evaluate the impact of combining action research theory with focus-solving short-term psychotherapy on the psychological stress, adjustment, and rehabilitation of patients with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI).
Methods: Between January 2022 and January 2023, a prospective study was conducted involving 300 AMI patients at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Participants were divided into a control group and a study group, with 150 patients in each.
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