Characteristics of STEMI Reperfusion Systems Identified

Common characteristics found in successful regional care systems can be benchmark standards

WEDNESDAY, May 23 (HealthDay News) -- Successful ST-segment elevation myocardial infarction (STEMI) reperfusion systems share common characteristics, and these characteristics can be used to set standards for coordinated care, according to research published online May 22 in Circulation: Cardiovascular Quality and Outcomes.

James G. Jollis, M.D., from Duke University in Durham, N.C., and colleagues surveyed 381 unique STEMI systems involving 899 percutaneous coronary intervention hospitals in 47 states to characterize the systems. Data were obtained through the American Heart Association Mission: Lifeline Web site. A qualified STEMI system was defined as an integrated group of separate entities within a geographic region, focusing on reperfusion therapy for STEMI and including at least one hospital that performs percutaneous coronary intervention and at least one emergency medical service agency.

The researchers found that the predominant system characteristics included: acceptance of STEMI patients at percutaneous coronary intervention hospitals, irrespective of bed availability (97 percent); activation of catheterization laboratory with a single phone call (92 percent); activation of laboratory by emergency department physicians without cardiology consultation (87 percent); participation in a data registry (84 percent); and pre-hospital activation of the laboratory through emergency department notification without cardiology notification (78 percent). Common barriers to system implementation were competition between hospitals and cardiology groups and difficulties with emergency medical services transport and finances.

"These findings serve as a benchmark for existing systems and should help guide health care teams in the process of organizing care for patients with STEMI," the authors write.

Two authors disclosed financial ties to the medical device and pharmaceutical industries.

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