Primary Angioplasty in Northern Galicia: Care Changes and Results Following Implementation of the PROGALIAM Protocol

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• 作者：Eduardo Barge-Caballero^a ; ^{blargesbueno@hotmail.com} ; Jos&#233 ; Manuel Vá ; zquez-Rodrí ; guez^a ; Rodrigo Est&#233 ; vez-Loureiro^a ; Ramó ; n Calviñ ; o-Santos^a ; Jorge Salgado-Ferná ; ndez^a ; Guillermo Aldama-Ló ; pez^a ; Pablo Piñ ; ó ; n-Esteban^a ; Xacobe Flores-Rí ; os^a ; Rosa Campo-P&#233 ; rez^a ; Jos&#233 ; Á ; ngel Rodrí ; guez-Ferná ; ndez^a ; Jos&#233 ; Antonio Lombá ; n-Villanueva^b ; Alejandro Mesí ; as-Prego^c ; Jos&#233 ; Manuel Guti&#233 ; rrez-Cort&#233 ; s^d ; Carlos Gonzá ; lez-Juanatey^e ; Carlos Portela^f ; Antonio Iglesias-Vá ; zquez^g ; Jacobo Varela-Portas Mariñ ; o^g ; Nicolá ; s Vá ; zquez-Gonzá ; lez^a ; Alfonso Castro-Beiras^a
• 关键词：CHUAC ; Complejo Hospitalario Universitario A Coruñ ; a (A Coruñ ; a University Hospital) ; EMS-061 ; Emergency Medical Service ; &ldquo ; dial 061&rdquo ; FMC-B ; first medical contact-to-balloon time ; PA ; primary angioplasty ; PROGALIAM ; Programa Galleg
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：65
• 期：4
• 页码：341-349
• 全文大小：555 K

文摘

Introduction and objectives

To analyze changes in healthcare delivery and results for primary angioplasty at Centro Hospitalario Universitario A Coru?a following implementation of the PROGALIAM protocol.

Methods

Observational registry of 1434 patients referred for primary angioplasty between 2003 and 2007. Results under PROGALIAM (May 2005 - December 2007; n=963) were compared with those from the preceding period (January 2003 - April 2005; n=388).

Results

After implementing PROGALIAM, there were increases in the number of primary angioplasty procedures (preceding period, 14.4 cases/month; PROGALIAM, 32.2 cases/month), mean patient age (preceding period, 61.3 (11.9) years; PROGALIAM, 64.2 (11.7) years; P<.001), and the percentage of patients referred from peripheral hospitals and treated after normal working hours. Overall median first medical contact-to-balloon time increased (previous period, 106 min; PROGALIAM, 113 min; P=.02), but decreased significantly among patients referred from noninterventional centers (previous period, 171 min; PROGALIAM, 146 min; P<.001). Percentage of cases with an first medical contact-to-balloon time <120 min remained unchanged among interventional-center patients (preceding period, 69 % ; PROGALIAM, 71 % ; P=.56) and increased among patients at noninterventional centers, although it remained low in this subgroup (preceding period, 17 % ; PROGALIAM, 30 % ; P=.04). Thirty-day mortality (preceding period, 5.2 % ; PROGALIAM, 6.2 % ; P=.85) and 1-year mortality (preceding period, 9.5 % ; PROGALIAM, 10.2 % ; P=.96) remained unchanged.

Conclusions

Implementation of PROGALIAM allowed us to increase the percentage of patients receiving primary angioplasty without jeopardizing the clinical results of this treatment.