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Heart Views. 2018 Oct-Dec;19(4):121-127. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_81_17.

Implementation of an ST-Segment Elevation Myocardial Infarction Bypass Protocol in the Northern United Arab Emirates.

Author information

1
National Ambulance, Abu Dhabi, UAE.
2
CQ University, Rockhampton, Australia.
3
Fanshawe College, Ontario, Canada.
4
Retrieval, Emergency and Disaster Medicine Research and Development Unit, University Hospital Limerick, Ireland, UK.
5
Cardiff University, Wales, UK.
6
Charles Sturt University, Bathurst, Australia.
7
Graduate Entry Medical School, University of Limerick, Ireland.

Abstract

Objective:

The aim was to evaluate the translation of an ST-segment elevation myocardial infarction (STEMI) bypass protocol to the outcomes of patients with acute coronary syndrome in the Emirate of Ras al-Khaimah in the United Arab Emirates (UAE).

Methods:

A prospective cohort study was conducted, which included all patients who had a prehospital 12-lead electrocardiogram (ECG) performed by ambulance crews. Analysis of those who were identified as having STEMI and who subsequently underwent percutaneous coronary intervention (PCI) was performed.

Results:

A total of 152 patients had a 12-lead ECG performed during the pilot study period (February 24, 2016-August 31, 2016) with 118 included for analysis. Mean patient age was 52 years. There were 87 male (74%) and 31 female (26%) patients. Twenty-nine patients suffered a STEMI, and data were available for 11 who underwent PCI. There was no mortality, and no major adverse cardiac events were reported. The median door-to-balloon (D2B) time was 73 min (range 48-124), and 81% of patients had a D2B time < 90 min. Discharge data were available for six patients: All were discharged home with no impediments to rehabilitation.

Conclusion:

This pilot study has demonstrated agreement with the existing literature surrounding prehospital ECG and PCI activation in an unstudied STEMI population and in a novel clinical setting. It has demonstrated a D2B time of < 90 min in over 80% of STEMI patients, and a faster mean D2B time than self-presentations (mean 77 min vs. 113 min), with no associated mortality or major adverse cardiac events.

KEYWORDS:

12-lead electrocardiogram; Middle East; ST-segment elevation myocardial infarction; myocardial infarct; percutaneous coronary intervention; prehospital

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