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ORIGINAL ARTICLE
Year : 2020  |  Volume : 21  |  Issue : 4  |  Page : 256-262

Clinical review: Management of patients with acute ST-elevation myocardial infarction


1 Department of Medicine, College of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen, Kingdom of Bahrain
2 Department of Cardiology, Sh. Mohammed Bin Khalifa Cardiac Center, Bahrain Defence Force Royal Medical Services, Kingdom of Bahrain

Correspondence Address:
Prof. Mary Lynch
Department of Cardiology, Sh. Mohammed Bin Khalifa Cardiac Center, Bahrain Defence Force Royal Medical Services
Kingdom of Bahrain
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_41_20

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Aims: The aim was to assess the quality of practice provided to acute ST-elevation myocardial infarction (STEMI) patients at the cardiac center, within a specified time frame and identify possible areas of improvement. Settings and Design: This is a retrospective standards-based clinical review, including adults diagnosed with acute STEMI between January 1, 2016 and January 1, 2017 of cases admitted and managed at the respective cardiac center. Subjects and Methods: The study was designed according to recommendations provided by the National Institute for Health and Care Excellence guidelines: “The acute management of myocardial infarction with ST-segment elevation;” alongside, the local standard: door-to-balloon time ≤90 min, adopted from the American Heart Association. Statistical Analysis Used: Data analysis was done through excel and SPSS for advanced statistical calculations. P < 0.05 was considered to be statically significant. Results: In total, 277 patients were included in the study. About 72% underwent primary percutaneous coronary intervention with 62 min as median door-to-balloon time. Door-to-balloon time >90 min was significantly higher when patients presented outside official hospital hours (P = 0.039). Transradial route was chosen in 77.7% of the cases. Conclusions: Practice at the cardiac center was found to show good compliance with the guidelines. However, door-to-balloon time for procedures performed out of official hospital working hours was slightly outside the recommended limit.


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