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Reduced ischemic time of acute coronary syndrome patients with indonesia telecardiology network: insights and challenges from a three year single center experience in West Jakarta

Session Poster Session 1

Speaker Anthony Paulo Sunjaya

Event : Acute Cardiovascular Care 2019

  • Topic : e-cardiology / digital health, public health, health economics, research methodology
  • Sub-topic : e-Cardiology - Other
  • Session type : Poster Session

Authors : AP Sunjaya (Jakarta,ID), AF Sunjaya (Jakarta,ID), A Priyana (Jakarta,ID)

Authors:
AP Sunjaya1 , AF Sunjaya1 , A Priyana2 , 1Tarumanagara University, Faculty of Medicine - Jakarta - Indonesia , 2Tarumanagara University-Cengkareng General Hospital, Department of Cardiology - Jakarta - Indonesia ,

Citation:

Background
Acute Coronary Syndrome (ACS) is the leading cause of morbidity and mortality globally and in Indonesia. Reduced time to reperfusion is crucial in slowing cardiac myocardium necrosis and improving prognosis in ACS patients. Previous studies in Indonesia have shown an inefficient transfer time for ACS patients. The use of telecardiology shows great potential to bridge this inefficiency and the Indonesian STEMI network (iSTEMI) was hence introduced in 2010.

Purpose
This study aims to evaluate the insights and challenges faced by iSTEMI telecardiology network over the past 3 years based on a single center experience in West Jakarta.

Methods
Data was obtained from the West Jakarta iSTEMI Network database acquired from the Department of Cardiology, General Hospital from the period of 30th June 2014 to 30th June 2017.

Results
A total of 2.017 ACS patients were admitted into the emergency department of the participating health centers during the period. Cengkareng General Hospital was the leading referral center with regards to the cases managed over the 3 periods, handling almost 50% of all cases in the region. Nine hundred and eighty-six ACS patients (48.9%) was subsequently diagnosed as STEMI, 85% of them were directly diagnosed by a cardiologist in the network of which, 437 (44.3%) of them were referred for reperfusion. While door to device time has slightly increased over the years from 104 minutes in year one to 115 minutes in the third year, door to needle time has also reduced to an almost equal extent from 80 minutes in year one to 75 minutes in the third year. Overall, over the three years patient ischemic time had reduced from a median of 330 minutes to 275 minutes, which was lower compared to the 416 minutes average ischemic time of the National Central Cardiovascular Center.

Conclusion
This study has shown a reduction in ischemic time in ACS patients through the use of a telecardiology network. Further development of telecardiology networks in Indonesia is therefore recommended to improve the quality of ACS care and save lives.

Variable

1st Year (N=147)

2nd Year (N=159)

3rd Year (N=95)

Median

(minutes)

Min - Max

Median

(minutes)

Min - Max

Median

(minutes)

Min - Max

Onset - FMC

120

25-640

150

21-710

150

15-700

Transfer Time

155

40-480

120

21-450

105

60-615

Door to Device

104

45-474

101.5

25-344

115

30-562

Door to Needle

80

27-325

85

16-360

75

10-330

Ischemic Time

330

75-705

330

65-710

275

90-780

FMC-first medical contact

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