Thirty-day mortality after the implantation of a system to provide rapid access to reperfusion therapy in acute myocardial infarction

Introduction and objectives The clinical impact of the systems for rapid access to reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI) has not been definitely established. The aim of this study is to investigate the effect on short term mortality of a myocardial infarction network organization (MINO). Methods A prospective single-center cohort study was designed, including all patients who met the following criteria: chest pain, less than 12 h since symptoms onset, and ST-segment elevation in at least 2 contiguous leads on the electrocardiogram. Results A total of 594 patients were included. MINO patients had both lower time since symptoms onset and lower time from arrival at the hospital to guidewire introduction in the culprit coronary artery: median of 190 min [IQR 130/270] vs 258 min [IQR 165/420] P 1 was detected in 36.4% vs 25.28%, respectively, P = .076. There were 45 deaths during 30-day follow-up, 5.6% in the MINO group vs 10.7%. Patients using MINO had better mid-term survival, log-rank test = 5.41, P = .02. However, in the multivariable Cox proportional hazard analysis, it was not associated with total mortality, HR, 0.71 (0.39–1.36). Conclusions In patients with STEMI, the set-up of a system to provide rapid reperfusion reduces the time to the opening of the culprit coronary artery. However, we did not find any difference in 30-day mortality rate in multivariable models.