Delay to reperfusion in patients with myocardial infarction in Santa Fe. It is time to develop a reperfusion-network

Abstract

Introduction: Time to reperfusion in myocardial infarction is crucial and can be optimized. The use of reperfusion networks has shown to be useful in improving delays. Objectives: to evaluate in-hospital outcomes in subjects with MI according to the distance of referral and to identify barriers associated with delays. Methods: all consecutive MI admitted between 2016 and 2023 were analyzed. The sample was divided into groups according to the referral distance: Zone 1 (Z1) Santa Fe, Zone 2 (Z2) ≤100 km, Zone 3 (Z3) >100 and ≤200 km and Zone 4 (Z4) >200 km. In-hospital outcomes were analyzed. All referral sites were contacted to identify challenges and causes of delays. Results: a sample of 408 STEMI was selected: 54.6% were from Z1, 27.9% from Z2, 13.7% from Z3 and 3.6% from Z4. It was observed that there was a significant difference between the referral zones and the time until admission (Z1 4 h, Z2 6 h, Z3 9 h y Z4 16 h (p<0.004). Reperfusion was performed at 70.1% and the most common cause of the lack of reperfusion was the delay (60.5%). Cardiogenic shock and mortality were higher according to the distance of the transfer (p=0.02 y p=0.01, respectively). Referral sites were contacted, and common causes of delay were identified. Conclusions: In-hospital outcomes are related to the delay to transfer. The implementation of networking might be useful to minimize this problem.