Introduction and objective: A limitation to the widespread use of primary angioplasty is delayed reperfusion. Most current data are from clinical trials and there is little information about the use of primary angioplasty in clinical practice. The objective of this study was to analyze the duration of each stage leading to primary angioplasty in a hospital where it is the treatment of choice for acute myocardial infarction.
Patients and method: Prospective observational study of patients admitted to our hospital from April 2000 to August 2001 for acute myocardial infarction with an indication for reperfusion. The time intervals from onset of symptoms until the end of angioplasty were analyzed.
Results: Primary angioplasty was performed in 201 of 218 patients with an indication for reperfusion (92%). Median values (percentiles 25-75) were: Time 1 (onset of symptoms-hospital arrival): 91 (50-150) minutes. Time 2 (hospital arrival-call to interventional team): 20 (10-49) minutes. Time 3: (call to interventional team-team arrival): 15 (0-20) minutes. Time 4: (team arrival patient arrival at the catheterization laboratory): 10 (5-15) minutes. Time 5 (patient arrival-opening of coronary artery): 20 (15-30) minutes. Time 6 (opening of coronary artery-TIMI III flow): 10 (0-25) minutes.
Conclusions: The most time-consuming stage in primary angioplasty was from the onset of symptoms until patient arrival at the hospital (Time 1). Inside the hospital, the most time-consuming stage was the diagnosis and decision to perform angioplasty (Time 2). The rates of primary angioplasty could be increased if delays in reperfusion were reduced with respect to those considered acceptable in current practice guidelines.