Abstract 3521: Relationship Between Time from Symptom Onset to Hospital Presentation and Treatment with and Timeliness of Reperfusion Therapy for Patients with ST-Elevation Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Henry H Ting ◽  
Elizabeth H Bradley ◽  
Yongfei Wang ◽  
Brahmajee K Nallamothu ◽  
Jeptha P Curtis ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Linear Models ◽  
Reperfusion Therapy ◽  
Subsequent Treatment ◽  
Time Intervals ◽  
St Elevation ◽  
Door To Balloon ◽  
The Relationship ◽  
Therapy Quality

Background: Whether patients with STEMI with longer times from symptom onset to hospital presentation are less likely to be treated with any reperfusion therapy or treated with less urgency resulting in longer door-to-balloon and door-to-needle times is not known. The relationship between delay in hospital presentation and the quality of reperfusion therapy for patients with STEMI has not been examined Methods: We constructed 3 cohorts of STEMI patients to analyze use of any reperfusion (n=440,398), door-to-balloon time (n=67,207), and door-to-drug time (n=183,441) as a function of delay in hospital presentation. We constructed multivariable generalized linear models for each outcome to estimate the associations between delay in hospital presentation adjusted for all patient and hospital characteristics. Results: In adjusted analysis, longer times from symptom onset to hospital presentation was associated with lower use of any reperfusion therapy (p<0.0001 for trend). For early presenters with times of ≤1 hour, >1 to 2 hours, and >2 to 3 hours, 77%, 77%, and 73% of patients received any reperfusion therapy, respectively, and late presenters with times >9 to 10 hours, >10 to 11 hours, and >11 to 12 hours were treated with any reperfusion therapy in 53%, 50%, and 46%, respectively. Delay in hospital presentation was associated with longer drug-to-balloon and door-to-drug times (p<0.0001 for trend). For time intervals of ≤ 1 hour, >1 to 2 hours, >2 to 3 hours, >9 to 10 hours, >10 to 11 hours, and >11 to 12 hours, patients with STEMI were treated with door-to-balloon times of 99, 101, 106, 123, 125, and 123 minutes respectively. For delay time intervals of ≤ 1 hour, >1 to 2 hours, >2 to 3 hours, >9 to 10 hours, >10 to 11 hours, and >11 to 12 hours, patients were treated with door-to-drug times of 32, 34, 36, 46, 44, and 46 minutes, respectively. Conclusions: Longer time from symptom onset to hospital presentation has important implications for subsequent treatment and was associated with lower use of any reperfusion therapy and longer door-to-balloon and door-to-drug times. Longer delay in hospital presentation is associated with worse system performance for reperfusion therapy quality and represents an opportunity to improve quality of care for STEMI patients.

scholarly journals The Relationship Between Family Support and the Quality of Post Primary PCI Patients’ Life

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Lailiyatul Munawaroh ◽  
Tuti Herawati
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Family Support ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
The Mean ◽  
The Relationship

<div><p class="Keywords"><strong>Objective: </strong>ST elevation myocardial infarction is the most common myocardial infarction cases. The main intervention of this case is primary percutaneous coronary intervention (PPCI). After PPCI, quality of life in STEMI patients depend on their ability to control the risk factors of reinfarction. In this condition, patients need family support. Therefore, this study aimed to identify the relationship between family support and quality of patients’ life after PPCI.<strong></strong></p><p class="Keywords"><strong>Methods: </strong>This was a descriptive study with cross sectional design. We recruited a purposive sample of 34 STEMI post- Primary PCI patients. We employed the modified family support questionnaire (Hensarling Diabetes Family Support Scale) and the quality of life questionnaire to collect data. Data, then, were analyzed using univariate and bivariate analyses.<strong></strong></p><p class="Keywords"><strong>Results: </strong>The mean score of the family support was 64.44, with the minimum score of 21 and maximum score of 75.  More patients received good family support than those who received poor family support. On the other hand, the mean score of patients’ life quality was 68.36, ranging from 25.1-98.43. There was a weak and positive correlation between family support and quality of patients’ life. However, the relationship was insignificant.<strong> </strong></p><p class="Keywords"><strong>Conclusion: </strong>Family support was not significantly related to quality of STEMI patients’ life. Further studies to identify factors contributing to the quality of STEI patients’ life are needed. </p><p class="Keywords"><strong>Key words: </strong>family support, percutaneous coronary intervention, quality of life, ST elevation myocardial infarction  <strong></strong></p></div>

Abstract 9764: Clinical Characteristics and Temporal Trends Among Patients Presenting Late (>12 Hours After Symptom Onset) With ST-Elevation Myocardial Infarction - A Report From the NCDR®

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Praneet K Sharma ◽  
Matthew T Roe ◽  
Faraz Kureshi ◽  
DaJuanicia N Holmes ◽  
Brahmajee K Nallamothu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Symptom Onset ◽  
Temporal Trends ◽  
Late Presentation ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
Hospital Outcomes ◽  
Late Presenters ◽  
St Elevation ◽  
Door To Balloon

Background: Late presentation after ST-elevation myocardial infarction (STEMI) is associated with poor outcomes. However, contemporary data regarding management and outcomes of such patients are lacking. Methods: Using data from the ACTION Registry-GWTG, we identified 170,247 patients who presented with STEMI to 688 US sites, between 7/08 and 12/13. Patients were stratified according to time from symptom onset to presentation as timely presenters (<12 hours) and late presenters (≥12 hours). Baseline characteristics, management and in-hospital outcomes were compared between the groups. Among late presenters, temporal trends in reperfusion strategy were also examined. Results: A total of 9389 patients (5.5%) had late presentation and 160,858 (94.5%) had timely presentation. Late presenters were more frequently elderly, female and of non-White ethnicity (Table). Late presenters were less likely to have prior MI or prior revascularization, but more likely to have diabetes. Compared with timely presenters, late presenters had worse in-hospital outcomes including mortality (6.3% vs. 5.2%; p<0.0001). Over the 6-year study period, the proportion of late presenters decreased slightly (5.8 vs. 5.4% respectively; p=0.03), while the proportion of late presenters undergoing primary PCI increased from 65% to 71% (p<0.001). Over the same time-period, among late presenters, median time from symptom onset to presentation increased slightly, door to balloon time decreased, and in-hospital mortality remained unchanged (6.0% vs. 6.0%). Conclusions: In contemporary practice, a modest proportion of STEMI patients continue to present >12 hours after symptom onset. Despite increased use of primary PCI and reduction in door-to-balloon times, the unadjusted mortality remains high among late presenters. Continued efforts to educate the public in order to reduce the proportion of late presenters remains warranted.

Comparison of Outcomes after Reperfusion Therapy between In-Hospital and Out-of-Hospital Stroke Patients

2015 ◽  
Vol 40 (1-2) ◽  
pp. 28-34 ◽  
Author(s):  
Joonsang Yoo ◽  
Dongbeom Song ◽  
Kijeong Lee ◽  
Young Dae Kim ◽  
Hyo Suk Nam ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Symptom Onset ◽  
Reperfusion Therapy ◽  
University Hospital ◽  
Time Interval ◽  
Time Intervals ◽  
Symptomatic Intracerebral Hemorrhage ◽  
All Cause Mortality ◽  
Tissue Plasminogen ◽  
Favorable Functional Outcome

Background: Patients may experience stroke while being admitted to the hospital (in-hospital stroke (IHS)) and they may be important candidates for reperfusion therapy. IHS patients may have various comorbidities and show worse outcomes compared with patients with an out-of-hospital stroke (OHS). On the other hand, the time from onset to treatment may be shorter in IHS patients than OHS patients. Most outcome studies of reperfusion therapy have been based on findings in OHS patients, and little information is currently available regarding outcomes of IHS, whether the outcomes differ between patients with IHS and those with OHS who receive reperfusion therapy. Methods: This is a retrospective observational study using prospectively registered data. Consecutive patients who underwent the reperfusion therapy (intravenous (IV), intra-arterial (IA), or combined IV and IA) between July 2002 and June 2014 in a university hospital were included for this study. We compared the demographics, time interval from symptom onset to treatment, and outcomes between IHS and OHS patients and analyzed the factors associated with in-hospital mortality. Results: A total of 686 patients received the reperfusion therapy during the study period. Of them, 256 (37.3%) patients received the IV tissue plasminogen activator (t-PA) therapy only, 243 (35.4%) patients received the IA therapy only, and 187 (27.3%) patients received the combined IV and IA therapy. Among these, 104 (15.2%) were IHS patients. The time intervals from symptom onset to IV t-PA administration (87.5 ± 48.4 vs. 113.4 ± 38.3 min, p < 0.001) and IA puncture (221.8 ± 195.0 vs. 343.6 ± 155.4 min, p < 0.001) were shorter for IHS than OHS. The rates of successful recanalization and symptomatic intracerebral hemorrhage, and the favorable functional outcome at 3 months were similar between the groups. In-hospital all-cause mortality was higher in IHS than OHS (16.3 vs. 8.4%, p = 0.019), but after adjustment, IHS was not an independent factor. The stroke mortality did not differ between the groups (9.6 vs. 6.9%, p = 0.432). Conclusions: Although IHS patients more frequently had comorbid diseases and higher overall in-hospital mortality, the standard outcomes of the reperfusion therapy were similar between IHS and OHS patients, which might be, in part, ascribed to the shorter interval from symptom onset to treatment in IHS. Considering a substantial portion of IHS patients, we should pay more attention to these patients.

scholarly journals Door-to-balloon Time for ST-elevation MI in the Coronavirus Disease 2019 Era

2021 ◽  
Vol 15 ◽  
Author(s):  
Haytham Mously ◽  
Nischay Shah ◽  
Zachary Zuzek ◽  
Ibrahim Alshaghdali ◽  
Adham Karim ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Treatment Modality ◽  
Arrival Time ◽  
Coronary Intervention ◽  
Hospital Arrival ◽  
Improved Outcomes ◽  
St Elevation ◽  
Door To Balloon ◽  
The Impact

In patients presenting with ST-elevation MI, prompt primary coronary intervention is the preferred treatment modality. Several studies have described improved outcomes in patients with door-to-balloon (D2B) and symptom onset-to-balloon (OTB) times of less than 2 hours, but the specific implications of the coronavirus disease 2019 (COVID-19) pandemic on D2B and OTB times are not well-known. This review aims to evaluate the impact of COVID-19 on D2B time and elucidate both the factors that delay D2B time and strategies to improve D2B time in the contemporary era. The search was directed to identify articles discussing the significance of D2B times before and during COVID-19, from the initialization of the database to December 1, 2020. The majority of studies found that onset-of-symptom to hospital arrival time increased in the COVID-19 era, whereas D2B time and mortality were unchanged in some studies and increased in others.

Effect of soil temperature during seed filling period on oleic/linoleic ratio, tocopherols and sugar contents in peanut kernels

2020 ◽  
Vol 71 (3) ◽  
pp. 369
Author(s):  
R. J. Haro ◽  
J. L. Dardanelli ◽  
M. J. Martínez
Keyword(s):  
Soil Temperature ◽  
Field Experiments ◽  
Linear Models ◽  
Positive Association ◽  
Seed Filling ◽  
Growth Environment ◽  
Sowing Dates ◽  
Relationship Of ◽  
The Relationship

The relationship of chemical quality of peanut seed with the soil temperature (ST) has received little attention. The aim of this work was to determine the effects of ST in the seed growth environment, during the seed filling period, on the oleic/linoleic acid (O/L) ratio, alpha, beta, gamma, delta tocopherols and the sum of them (TT), fructose, glucose and sucrose and the sum of them (FGS), contents in peanut kernels. Field experiments included cultivars (Florman and ASEM), water regimes (irrigated and water stress), sowing dates and alteration of ST. The response of O/L ratio to ST fitted a linear model, where the O/L ratio increased while ST increased. Mean O/L ratios were 1.31 for ASEM and 1.20 for Florman. The TT mean concentration was similar for both genotypes (478 ppm). A positive association between α-tocopherol (the main source of vitamin E) and ST, and a negative association between δ and α tocopherols were detected. The responses of FGS and sucrose to ST fitted linear models, where increments in ST showed decreases in FGS and sucrose concentrations. However, the decrease rates of FGS and sucrose in ASEM were three times lower than in Florman. The results showed that ST affected the chemical composition of peanut kernels, which mainly determines the shelf life and flavor of both genotypes differentially.

Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis

Heart ◽  
2018 ◽  
Vol 104 (16) ◽  
pp. 1362-1369 ◽  
Author(s):  
Chee Yoong Foo ◽  
Kwadwo Osei Bonsu ◽  
Brahmajee K Nallamothu ◽  
Christopher M Reid ◽  
Teerapon Dhippayom ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Short Term ◽  
Percutaneous Coronary ◽  
Short Term Mortality ◽  
St Elevation ◽  
Door To Balloon ◽  
Prehospital Delays ◽  
The Relationship

ObjectiveThis study aims to determine the relationship between door-to-balloon delay in primary percutaneous coronary intervention and ST-elevation myocardial infarction (MI) outcomes and examine for potential effect modifiers.MethodsWe conducted a systematic review and meta-analysis of prospective observational studies that have investigated the relationship of door-to-balloon delay and clinical outcomes. The main outcomes include mortality and heart failure.Results32 studies involving 299 320 patients contained adequate data for quantitative reporting. Patients with ST-elevation MI who experienced longer (>90 min) door-to-balloon delay had a higher risk of short-term mortality (pooled OR 1.52, 95% CI 1.40 to 1.65) and medium-term to long-term mortality (pooled OR 1.53, 95% CI 1.13 to 2.06). A non-linear time–risk relation was observed (P=0.004 for non-linearity). The association between longer door-to-balloon delay and short-term mortality differed between those presented early and late after symptom onset (Cochran’s Q 3.88, P value 0.049) with a stronger relationship among those with shorter prehospital delays.ConclusionLonger door-to-balloon delay in primary percutaneous coronary intervention for ST-elevation MI is related to higher risk of adverse outcomes. Prehospital delays modified this effect. The non-linearity of the time–risk relation might explain the lack of population effect despite an improved door-to-balloon time in the USA.Clinical trial registrationPROSPERO (CRD42015026069).

scholarly journals Reperfusion Therapy for ST-Elevation Myocardial Infarction at Dr. Soetomo General Academic Hospital Surabaya

2021 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Rosavelina Sintaasih Budihardjo ◽  
Agus Subagjo ◽  
Subur Prajitno
Keyword(s):  
Cardiovascular Disease ◽  
Simple Random Sampling ◽  
Reperfusion Therapy ◽  
Academic Hospital ◽  
St Segment ◽  
St Elevation ◽  
Observation Method ◽  
Door To Balloon ◽  
Descriptive Statistical Analysis

Background: Cardiovascular disease is the number one cause of death in the world by killing 17,9 million people every year. The most frequent cardiovascular disease occurs as STEMI which related to the depiction of persistent depiction of EKG elevation with ST segment. This research is aiming for figure out the profile of reperfusion therapy at Dr. Soetomo General Academic Hospital, Surabaya. Methods: In this research, the data is collected using observation method, without any treatment applied with descriptive statistical analysis using table. The data collection techniques used is simple random sampling. Results: The STEMI patients at Dr. Soetomo General Academic Hospital Surabaya are dominated by referral patients (79,2%) from approximately 40 hospitals in East Java. Most of the patients were male, the ages between 51 – 60 years old with the most frequent risk factors was the combination of type 2 diabetes mellitus, hypertension, and smoking. The reperfusion therapy given was PCI with a door to balloon <120 minutes was 59.6%. Fibrinolytic that was done in <12 hours after onset was 82.9%. Patients with STEMI managed at Dr. Soetomo General Academic Hospital Surabaya, had mortality rates around 12.2%. Conclusion: Most of the STEMI patients in Dr. Sutomo General Academic Hospital Surabaya was a referral patient and had sufficiently good PCI and fibrinolytic reperfusion therapy, resulting in a low mortality rate.

scholarly journals Factors Affecting the Presence and the Diversity of Bryophytes in the Petrifying Sources Habitat (7220) in Wallonia and the Brussels-Capital Region, Belgium

2016 ◽  
Vol 2016 ◽  
pp. 1-18 ◽  
Author(s):  
J.-M. Couvreur ◽  
G. San Martin ◽  
A. Sotiaux
Keyword(s):  
Species Richness ◽  
Environmental Factors ◽  
Community Composition ◽  
Linear Models ◽  
Canopy Cover ◽  
Individual Species ◽  
Factors Affecting ◽  
The Relationship ◽  
Main Factor

Bryological composition, water chemistry, and environmental factors were characterized on 67 Belgian travertines. We explore the relationship between these environmental factors and the community composition, species richness, or presence of individual species using Redundancy Analysis with Hellinger’s transformation (tb-RDA) or Generalized Linear Models (GLMs). The best variables explaining the community composition are slope, NO3, NH4, and PO4. The species richness is negatively related to canopy cover and PO4.Palustriella commutatatends to be more frequent when the slope is steeper and to a lesser degree when the canopy cover is lower.Eucladium verticillatumtends to be slightly more frequent when canopy cover and NH4concentrations are lower.Cratoneuron filicinumis more frequent at higher Mg concentrations andPellia endiviifoliais more frequent at lower PO4concentrations and higher NO3concentrations.Brachythecium rivulareshowed wide ecological amplitude and almost none of the tested environmental factors seem to be related to its presence. The study identifies eutrophication as the main factor responsible for habitat deterioration. Practical indications on the best ways to maintain or to enhance the quality of these petrifying sources are given.

scholarly journals The Psychosocial Benefits of Sport Participation During COVID-19 Are Only Partially Explained by Increased Physical Activity

2022 ◽  
Author(s):  
Andrew M Watson ◽  
Kevin Biese ◽  
Claudia Reardon ◽  
Allison Schwarz ◽  
Kristin Haraldsdottir ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Sport Participation ◽  
Linear Models ◽  
Instruction Type ◽  
The Difference ◽  
Psychosocial Benefits ◽  
Anxiety Depression ◽  
The Relationship

The purpose of this study was to determine whether physical activity (PA) increases were responsible for the improvements in mental health and quality of life (QOL) seen among adolescents who returned to sport during the COVID-19 pandemic. Adolescent athletes were asked to complete a survey in October 2020 regarding demographic information, whether they had returned to sport participation (no [DNP], yes [PLY]), school instruction type (virtual, in-person, hybrid), anxiety, depression, QOL, and PA. Anxiety, depression, QOL and PA were compared between PLY and DNP using least squares means from linear models adjusted for age, gender, and instruction type. Mediation analysis assessed whether the relationship between sport status and anxiety, depression, and QOL was mediated by PA. 171 athletes had returned to play, while 388 had not. PLY athletes had significantly lower anxiety (3.6 +/- 0.4 v 8.2 +/- 0.6, p < 0.001) and depression (4.2 +/- 0.4 v 7.3 +/- 0.6, p < 0.001), and significantly higher QOL (88.1 +/- 1.0 v 80.2 +/- 1.4, p < 0.001) and PA (24.0 +/- 0.5 v 16.3 +/- 0.7, p < 0.001). PA explained a significant, but relatively small portion of the difference in depression (22.1%, p = 0.02) and QOL (16.0%, p = 0.048) between PLY and DNP athletes, but did not explain the difference in anxiety (6.6%, p = 0.20). Increased PA is only responsible for a small portion of the improvements in depression and QOL among athletes who returned to sports and unrelated to improvements in anxiety. This suggests that the majority of the mental health benefits of sport participation for adolescents during the COVID-19 pandemic are independent of, and in addition to, the benefits of increased PA.

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