Time delays in each step from symptom onset to treatment in acute myocardial infarction: Results from a nation-wide TURKMI registry

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dc.contributor.authorErol, Mustafa Kemal
dc.contributor.authorKayikcioglu, Meral
dc.contributor.authorKilickap, Mustafa
dc.contributor.authorGuler, Arda
dc.contributor.authorOzturk, Onder
dc.contributor.authorTuncay, Burcu
dc.contributor.authorInci, Sinan
dc.date.accessioned2024-02-23T14:41:02Z
dc.date.available2024-02-23T14:41:02Z
dc.date.issued2021
dc.departmentNEÜen_US
dc.description.abstractObjective: In this study, we aimed to analyze the TURKMI registry to identify the factors associated with delays from symptom onset to treatment that would be the focus of improvement efforts in patients with acute myocardial infarction (AMI) in Turkey. Methods: The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of 24/7 primary percutaneous coronary intervention (PCI). All consecutive patients (n=1930) with AMI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018, and November 16, 2018. All the patients were examined in detail with regard to the time elapsed at each step from symptom onset to initiation of treatment, including door-to-balloon time (D2B) and total ischemic time (TIT). Results: After excluding patients who suffered an AMI within the hospital (2.6%), the analysis was conducted for 1879 patients. Most of the patients (49.5%) arrived by self-transport, 11.8% by emergency medical service (EMS) ambulance, and 38.6% were transferred from another EMS without PCI capability. The median time delay from symptom-onset to EMS call was 52.5 (15-180) min and from EMS call to EMS arrival 15 (10-20) min. In ST-segment elevation myocardial infarction (STEMI), the median D2B time was 36.5 (25-63) min, and median TIT was 195 (115-330) min. TIT was significantly prolonged from 151 (90-285) min to 250 (165-372) min in patients transferred from non-PCI centers. The major significant factors associated with time delay were patient-related delay and the mode of hospital arrival, both in STEMI and non-STEMI. Conclusion: The baseline evaluation of the TURKMI study revealed that an important proportion of patients presenting with AMI within 48 hours of symptom onset reach the PCI treatment center later than the time proposed in the guidelines, and the use of EMS for admission to hospital is extremely low in Turkey. Patient-related factors and the mode of hospital admission were the major factors associated with the time delay to treatment.en_US
dc.description.sponsorshipTurkish Society of Cardiology from AstraZenecaen_US
dc.description.sponsorshipStatistical analyses were conducted by Omega CRO, Ankara, Turkey. The electronic case report form and the data capture program (OpenClinica LLC and collaborators, Waltham, MA, USA) hosted were by Omega CRO, Ankara, Turkey. TURKMI registries are investigator-initiated trials and sponsored by the Turkish Society of Cardiology, which received major, unrestricted funding from AstraZeneca for this project. The funder had no role in study design, data collection, data analysis, data interpretation, or writing of the report.en_US
dc.identifier.doi10.5152/AnatolJCardiol.2021.39797
dc.identifier.endpage303en_US
dc.identifier.issn2149-2263
dc.identifier.issn2149-2271
dc.identifier.issue5en_US
dc.identifier.pmid33960304en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage294en_US
dc.identifier.urihttps://doi.org/10.5152/AnatolJCardiol.2021.39797
dc.identifier.urihttps://hdl.handle.net/20.500.12452/16676
dc.identifier.volume25en_US
dc.identifier.wosWOS:000648811900003en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherKare Publen_US
dc.relation.ispartofAnatolian Journal Of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectMyocardial Infarctionen_US
dc.subjectAmbulanceen_US
dc.subjectTotal Ischemic Timeen_US
dc.subjectTreatment Delayen_US
dc.subjectDoor To Balloon Timeen_US
dc.titleTime delays in each step from symptom onset to treatment in acute myocardial infarction: Results from a nation-wide TURKMI registryen_US
dc.typeArticleen_US

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