ST-elevation Myocardial Infarction Clinical Trial
Official title:
Helicopter Versus Ground Emergency Medical Systems and the Effect on Mortality and Labour Market Affiliation of Patients Bound for Percutaneous Coronary Intervention
This study compares patients bound for Percutaneous Coronary Intervention (PCI) who were transported by either ground ambulance or emergency medical helicopter. The investigators describe long-term follow-up in relation to mortality and labour affiliation.
Since 2003, percutaneous coronary intervention (PCI) for ST-Segment elevation myocardial
infarction (STEMI) has been the preferred therapy in Denmark over fibrinolysis
(thrombolysis) if performed within 120 minutes. Nevertheless, centralisation of designated
PCI-centres may lead to systems delays as transport distance may be longer instead of just
choosing thrombolysis at the nearest hospital.
As every minute counts when trying to minimize the ischemic injury and size of infarction
following an acute coronary event, timely transportation by helicopter may facilitate
overall prognosis.
As a part of a national initiative to improve prehospital care of patients with time
critical illness such as myocardial infarction (MI), the first Danish Helicopter Emergency
Medical System (HEMS) was implemented in the eastern part of Denmark May 1st 2010.
An initial study on 450 patients investigating short-term effects, found that HEMS
significantly reduced time from the first electrocardiogram (ECG) diagnosis on-scene to
arrival at the cardiac catheterisation laboratory (CCL) despite longer transport distances.
Investigators also found a lower, but insignificant 30-day mortality in HEMS patients,
adjusted OR=0.40 (95% CI=0.12-1.39, p=0.14).
The aim of the present study is to investigate long-term effects of HEMS in relation to
mortality and labour market affiliation.
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Observational Model: Cohort, Time Perspective: Prospective
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