Effect of Cardiac Catheterization Personnel On Time to Treatment for Myocardial Infarction

Richard R Wall; Jeffrey S Legg; Ernie Steidle; Timmerie F Cohen; Melanie C Dempsey; Salman Akhtar

Effect of Cardiac Catheterization Personnel On Time to Treatment for Myocardial Infarction

Radiol Technol. 2022 Mar;93(4):368-377.

Authors

Richard R Wall¹, Jeffrey S Legg², Ernie Steidle³, Timmerie F Cohen⁴, Melanie C Dempsey⁵, Salman Akhtar⁶

Affiliations

¹ Richard R Wall, PhD, R.T.(R)(CT)(CI), RCIS, is cardiac interventional radiographer for Spring Valley Hospital Medical Center in Las Vegas, Nevada.
² Jeffrey S Legg, PhD, R.T.(R)(CT)(QM), FASRT, is associate professor and chair for the Virginia Commonwealth University (VCU) Department of Radiation Sciences in Richmond.
³ Ernie Steidle, PhD, is faculty in the VCU Doctoral Program in Health Related Sciences in Richmond.
⁴ Timmerie F Cohen, PhD, R.T.(R)(T), CMD, is associate professor and clinical coordinator of radiation therapy for VCU and is vice chair of the Radiation Therapist Editorial Review Board.
⁵ Melanie C Dempsey, PhD, R.T.(R)(T), CMD, FAAMD, is associate professor and program director of radiation therapy for VCU in Richmond.
⁶ Salman Akhtar, MD, FACC, FSCAI, is a retired cardiologist from Cardiovascular Specialists in Las Vegas, Nevada.

PMID: 35260485

Abstract

Purpose: To evaluate the effect of physician and nonphysician cardiac catherization laboratory personnel on the treatment of myocardial infarction.

Methods: Admissions data from 4 Las Vegas, Nevada hospitals were analyzed via multivariate regression analysis to determine predictors of reperfusion times. The goal for reperfusion is a door-to-balloon time of less than 90 minutes.

Results: Prehospital ST-segment elevation myocardial infarction (STEMI) activation, cardiologist arrival time, lifesaving measures, door-to-electrocardiogram (ECG) time, time and day, critical diagnostic examinations, and door-to-first-medical-doctor time all significantly affected door-to-balloon time. However, cardiac catheterization laboratory (CCL) staff arrival time did not affect door-to-balloon time.

Discussion: This study confirms the well-established importance of prehospital ECG and STEMI protocol activation. The results also indicate the importance of cardiologist arrival time on reperfusion times as this explained a significant amount of the explained variance in door-to-balloon time. CCL team arrival time did not affect door-to-balloon time, dispelling a long-held belief that reducing the response time of the CCL team significantly reduced reperfusion times.

Conclusion: Although cardiologist arrival time influenced door-to-balloon time, CCL staff arrival time did not. Programs to provide greater laboratory coverage might help improve reperfusion times as well as assist STEMI program coordinators in developing more efficient protocols.

Keywords: ST-segment myocardial infarction; cardiac catheterization; door-to-balloon time; percutaneous coronary intervention; reperfusion.

MeSH terms

Angioplasty, Balloon, Coronary* / methods
Cardiac Catheterization
Electrocardiography
Emergency Service, Hospital
Humans
Myocardial Infarction* / therapy
Time Factors
Time-to-Treatment