Usefulness of the regional medical cooperation system in managing acute myocardial infarction

Abstract

Reperfusion of the coronary artery within a few hours from the onset of acute myocardial infarction (AMI) is important for patients' care. This study investigated the effect of family physician intervention on the promptness of acute coronary syndrome treatment.
From a total of 403 patients who underwent percutaneous coronary intervention at our acute care hospital for the diagnosis of AMI between April 2014 and March 2019, 187 consecutive patients who visited during the daytime on business days were included in this study. Patients were divided into two groups：with and without referral from other medical facilities (clinics and hospitals)；i.e., a home-D group and a direct group, respectively. The time from arrival at our hospital to reperfusion (door-to-balloon-time：DTBT), time from chest pain onset to reperfusion, and peak value of creatine kinase (peak CK) were compared between the two groups. DTBT was significantly shorter in the home-D group (93 ± 51 minutes, direct 128 ± 81 minutes：P = 0.010). However, the time from onset to reperfusion was significantly shorter in the direct group (519 ± 402 minutes, direct 370 ± 337 minutes：P = 0.017), although there was no significant difference in the peak CK value. This study indicated that this system also contributed to the reduction in DTBT. However, further improvement of the cooperation system is required to reduce the onset to reperfusion time.