0139 : Extrahospital troponin measurement before admission for a ST segment elevation myocardial infarction

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• 作者：Jean-Claude Beer¹ ; Emmanuel Debost² ; Auré ; lien Vaillant³ ; Maud Maza¹ ; Luc Rochette⁴ ; Marianne Zeller⁴ ; ^{marianne.zeller@u-bourgogne.fr" class="auth_mail" title="E-mail the corresponding author} ; Yves Cottin¹
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：8
• 期：3
• 页码：205
• 全文大小：48 K

文摘

Early and reliable triage of patients is of major importance to promote rapid and appropriate treatments of patients with ST segment elevation myocardial infarction (STEMI). Extrahospital troponin measurement is used in primary care setting to help the identification of patients with suspected MI. From a regional survey (RICO), we aimed to investigate the frequence and hospital prognosis of STEMI patients with prehospital troponin (PT) measurement.

Methods and results

Prospective study on 799 consecutive patients with STEMI included in RICO from March 2013 – 31 may 2015. Among the 799 patients, 38(5%) were identified with PT, from source files and patient's interview. When compared with patients without PT (n=761), PT group had much longer prehospital delays, including median time from symptom onset (SO) to 1st intervention, SO to admission and time from 1st intervention to admission (p<0.001 for all). Time from SO to 1st call was also markedly increased (11H45 vs 1H45, p<0.001). Rate of primary PCI was significantly decreased in PT group (79 vs 90%, respectively, p<0.001). Age and risk factors were similar in both groups. PT patients had less frequently prior MI, higher heart rate on admission (88 vs 78 b/min, respectively, p=0.041), and had GRACE risk score with a trend toward an elevation (165 vs 152, respectively, p=0.157). In contrast, PT patients had more frequently preinfarction angina (53 vs 31%, p=0.038, respectively). Severity criteria including altered LVEF and Nt-proBNP level was increased (45 vs 50%, p= 0.030 and 2382 vs 402 pg/mL, p<0.001). The rate of hospital complication including heart failure and death was similar in the 2 groups (29 vs 26%, p=0.730 and 8 vs 8%, p=0.975, respectively).

Conclusion

Our study suggest that in STEMI patients, less acute clinical presentation could explain the longer prehospital delays to treatment, and consequently more severity criteria associated with PT.

The author hereby declares no conflict of interest