Outcome of Patients With Acute Coronary Syndrome Admitted to Hospitals With or Without Onsite Cardiac Catheterization Laboratory

Abstract Background In case of suspected acute coronary syndrome (ACS), international guidelines recommend to obtain a 12-lead ECG as soon as possible after first medical contact, to administrate platelet aggregation inhibitors and antithrombins, and to transfer the patient as quickly as possible to an emergency department. Methods A German emergency care service database was retrospectively analysed from 2014 to 2016. Data were tested for normal distribution and the Mann–Whitney test was used for statistical analysis. Results are presented as medians (IQR). Results A total of 1424 patients with suspected ACS were included in the present analysis. A 12-lead ECG was documented in 96% of patients (n = 1369). The prehospital incidence of ST-segment elevation myocardial infarction (STEMI) was 18% (n = 250). In 981 patients (69%), acetylsalicylic acid (ASA), unfractionated heparin (UFH), or ASA and UFH was given. Time in prehospital care differed significantly between non-STEMI (NSTEMI) ACS (37 [IQR 30, 44] min) and STEMI patients (33 [IQR 26, 40] min, n = 1395, p < 0.0001). Most of NSTEMI ACS and STEMI patients were brought to the emergency care unit, while 30% of STEMI patients were directly handed over to a cardiac catheterization laboratory. Conclusions Prehospital ECG helps to identify patients with STEMI, which occurs in 18% of suspected ACS. Patients without ST-elevations suffered from longer prehospital care times. Thus, it is tempting to speculate that ST-elevations in patients prompt prehospital medical teams to act more efficiently while the absence of ST-elevations even in patients with suspected ACS might cause unintended delays. Moreover, this analysis suggests the need for further efforts to make the cardiac catheterization laboratory the standard hand-over location for all STEMI patients.

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In-Hospital Cardiac Arrest in the Cardiac Catheterization Laboratory: Effective Transition from an ICU- to CCU-Led Resuscitation Team

Journal of Interventional Cardiology ◽

10.1155/2019/1686350 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8

Author(s):

Rajat Sharma ◽

Hilary Bews ◽

Hardeep Mahal ◽

Chantal Y. Asselin ◽

Megan O’Brien ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiac Catheterization ◽

Tertiary Care ◽

Pulseless Electrical Activity ◽

Hospital Length Of Stay ◽

Health Concern ◽

Catheterization Laboratory ◽

Cardiac Catheterization Laboratory ◽

Coronary Syndrome ◽

Code Blue

Objectives. (1) To examine the incidence and outcomes of in-hospital cardiac arrests (IHCAs) in a large unselected patient population who underwent coronary angiography at a single tertiary academic center and (2) to evaluate a transitional change in which the cardiologist is positioned as the cardiopulmonary resuscitation (CPR) leader in the cardiac catheterization laboratory (CCL) at our local tertiary care institution. Background. IHCA is a major public health concern with increased patient morbidity and mortality. A proportion of all IHCAs occurs in the CCL. Although in-hospital resuscitation teams are often led by an Intensive Care Unit- (ICU-) trained physician and house staff, little is known on the role of a cardiologist in this setting. Methods. Between 2012 and 2016, a single-center retrospective cohort study was performed examining 63 adult patients (70 ± 10 years, 60% males) who suffered from a cardiac arrest in the CCL. The ICU-led IHCAs included 19 patients, and the Coronary Care Unit- (CCU-) led IHCAs included 44 patients. Results. Acute coronary syndrome accounted for more than 50% of cardiac arrests in the CCL. Pulseless electrical activity was the most common rhythm requiring chest compression, and cardiogenic shock most frequently initiated a code blue response. No significant differences were observed between the ICU-led and CCU-led cardiac arrests in terms of hospital length of stay and 1-year survival rate. Conclusion. In the evolving field of Critical Care Cardiology, the transition from an ICU-led to a CCU-lead code blue team in the CCL setting may lead to similar short-term and long-term outcomes.

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Myocardial Revascularization in COVID-19 Era

Heart Science Journal ◽

10.21776/ub.hsj.2021.002.03.1 ◽

2021 ◽

Vol 2 (3) ◽

pp. 1-4

Author(s):

Sasmojo Widito

Keyword(s):

Acute Coronary Syndrome ◽

Severe Acute Respiratory Syndrome ◽

Clinical Benefit ◽

Healthcare Professionals ◽

Myocardial Revascularization ◽

Catheterization Laboratory ◽

Cardiac Catheterization Laboratory ◽

Coronary Syndrome ◽

Need To Evaluate ◽

Benefit And Risk

Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the coronavirus 2 that causes severe acute respiratory syndrome (SARS-CoV-2). More discussion is required to achieve the balance between clinical benefit and risk in the treatment of acute coronary syndrome (ACS) patients with COVID-19. The current COVID-19 pandemic prompts the need to evaluate criteria for indication and efficacy of the general safety protocols and particular cardiac catheterization laboratory (CCL) procedures to safeguard the patient and healthcare professionals

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Off-the-shelf barrier for emergency intubation in the cardiac catheterization laboratory during the coronavirus disease 2019 (COVID-19) pandemic

Clinical Research in Cardiology ◽

10.1007/s00392-020-01696-9 ◽

2020 ◽

Vol 109 (12) ◽

pp. 1507-1509

Author(s):

Bruno Scheller ◽

Davor Vukadinovic ◽

Sebastian Ewen ◽

Felix Mahfoud

Keyword(s):

Acute Coronary Syndrome ◽

Lead Glass ◽

Protection Device ◽

Transparent Plastic ◽

Catheterization Laboratory ◽

Cardiac Catheterization Laboratory ◽

Coronary Syndrome ◽

Plastic Bag ◽

Protective Cover ◽

Protection Devices

AbstractWith the spread of SARS-CoV-2, it is expected that cases of acute coronary syndrome in the setting of coronavirus disease 2019 (COVID-19) develop. As expensive and sophisticated protection devices are not widely available, we have been working on a simple, off-the-shelf protection device for endotracheal intubation of potentially infected patients. For this purpose, we used a large transparent plastic bag (such as the sterile protective cover of the lead glass shield) for protection from airborne infections. The cover is moved over the patient's head from cranial to caudal, covering the catheter table including the torso with no need for patient mobilization. The intubation is done conventionally under direct visual control.

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