Implementation of STEMI Communication Network System in Malang to Accelerate Door-to-Balloon Times

Astrid Pramudya () and Mohammad Saifur Rohman
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Astrid Pramudya: Universitas Brawijaya, Department of Cardiology and Vascular Medicine Saiful Anwar General Hospital
Mohammad Saifur Rohman: Universitas Brawijaya, Department of Cardiology and Vascular Medicine Saiful Anwar General Hospital

A chapter in Proceedings of the 2023 Brawijaya International Conference (BIC 2023), 2024, pp 61-66 from Springer

Abstract: Abstract Patient delay is a worldwide unsolved problem in ST-segment elevated myocardial infarction (STEMI). An accurate networking system will provide delightful reperfusion management and better outcomes. To implement STEMI communication network system among Saiful Anwar General Hospital with all of the Public Health Centers (PHC) around Malang region to shorten the door to balloon times and reduce MACE. A retrospective cohort study enrolled 184 consecutive patients with STEMI. 96 were non network and 88 network patients. Statistical tests using SPSS version 20.0 software. The mean ± SD door-to-balloon (D2B) time was significantly shortened from 270,5±128 minutes to 193±85 minutes (P=0.026). Multivariate analysis without confounder showed that the network-group had significantly shorter door-to-reperfusion time (p=0.032) and lower MACE (p=0.01) compared to the non-network group. But multivariate analysis with confounder door-to-balloon and door-to-needle failed to explain lower MACE incidence. Network-group (p=0.005) and reperfusion with primary PCI (p=0.05) significantly decreased MACE incidence. Although the percentage is less than 50%, a significant increase in the percentage of D2B times less than 90 minutes in the network group vs the non network group with 18.5% vs 5.2% (P=.097). Implementation of the STEMI communication network system in Malang significantly reduced the D2B time, although the corresponding increase in the percentage of D2B times less than 90 minutes is not yet achieved. It also reduced MACE in STEMI patients undergoing primary PCI.

Keywords: STEMI; networking system; door to balloon; MACE (search for similar items in EconPapers)
Date: 2024
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DOI: 10.2991/978-94-6463-525-6_7

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