J Transcat Intervent.2018;26:a0014.
Implementing telemedicine in the initial care for ST-segment elevation myocardial infarction
DOI: 10.31160/JOTCI2018;26(1)A0014
ABSTRACT
Background
In ST-segment elevation myocardial infarction, the need for early recanalization of the culprit artery, associated to the difficult access of the general population to medical services that provide such treatment, contribute to increased mortality in such patients. This is the rationale for implementing the LATIN project, acronym for Latin America Telemedicine Infarct Network, in areas characterized by high demographic density and difficult access to healthcare services. The objective of the present study was to analyze the first year results of this project.
Methods
The sample included six centers with telemedicine systems participating in the LATIN registry. In cases of acute myocardial infarction, the electrocardiogram and clinical summary were sent to the mobile phones of the interventional cardiologists at the reference hospital. Clinical and angiographic characteristics, intervals between care delivered and hospital outcomes were analyzed.
Results
From June 2014 to June 2015, a total of 125 patients were enrolled, mean age of 58.3±11.1 years, 66.4% males, 30.4% suffering from diabetes mellitus and 28.8% smokers. A total of 85 primary percutaneous coronary interventions were performed with a mean door-to-balloon time of 46.4±25.0 minutes. The pharmaco-invasive strategy was adopted in 20.0% of patients. In-hospital mortality was 5.6%.
Conclusions
The telemedicine system was a valuable partner in early diagnosis and rapid initiation of the gold standard treatment for acute myocardial infarction in the region analyzed, with possible impact in survival, cost reduction and morbimortality.
Keywords: Angioplasty; Myocardial infarction; Telemedicine; Time-to-treatment
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