Vol. 48 | No. 1 | January-June 2020 Back

Open Access

The Impact of 24/7 On-call Schedule of Interventional Cardiologists on the PCI Outcomes of STEMI Patients (ICONIC POST Study)

Ramon Christian S.M. Villasis, Paolo A. Prado
Jun 2020 DOI 10.69944/pjc.341cf00178

Abstract

INTRODUCTION: Percutaneous coronary intervention (PCI) is the preferred treatment for ST elevation myocardial infarction (STEMI) and should be done within the recommended door-to balloon time (D2B) of 90 minutes or less. Progressive delays between onset of symptoms and PCI result in significantly higher in-hospital and long-term mortality. Various initiatives are done to  augment timely administration of PCI. 

METHODS: This ambidirectional cohort study was conducted to investigate the effect of  implementing a 24/7 on-call schedule of interventional cardiologists on D2B and In- hospital all cause mortality of STEMI patients admitted in a local tertiary hospital. The study entailed review  of the Cardiovascular Institute’s AMI Data registry and Chest Pain Pathway Data from September  14, 2015 until Sept 15, 2018.  

RESULTS: Eighty-seven patients, 32 to 85 years old, with STEMI and underwent emergent  PCI were included in this study. The results of data analyses showed decreasing trend in D2B  of the Revised group compared to the Baseline group (mean D2Bbaseline 116 minutes vs. mean  D2Brevised 113.48 minutes). Decreasing trend was also noted in the Disposition-to-Balloon  time (Dis2B) (mean Dis2Bbaseline=94.3 minutes vs mean Dis2Brevised=85.6 minutes). The results  further showed 4% mortality decrease during the Revised period (Mortalitybaseline 11.1% vs.  Mortalityrevised=7.1%). However, these observed differences were not statistically significant. In  terms of D2B, the institution lags behind the international standard but performs better compared  to the nationwide performance of 1,249.43 minutes in the Philippine ACS Registry. This study  supports the continuation of the on-call schedule among interventionist responding to STEMI  cases. 

KEYWORDS: 24/7 On-call schedule, Door-to-balloon time, Disposition-to-baloon time, Mortality,  STEMI

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