Association of age on the time of primary pci activation for stemi patients at emergency department

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Strategic Health Research and Innovation Plan (PERIS) 2016-2020

Time between arrival at the Emergency Department (ED) and STEMI activation is a good indicator of the ED quality. Times of attention are of particular importance in some STEMI subgroups, such as elderly. Elderly patients are underdiagnosed and inadequately treated, resulting in a worse prognosis and survival rate.

To determine association of age with the activation time in STEMI patients admitted to ED.

An observational retrospective study was conducted including all patients admitted to the ED activated as a STEMI between 2013 and 2016. The main variable was the activation time, defined as the time between ED arrival and primary PCI activation.

A total of 330 patients were included. They were classified by age: 51.1% (167) <65 years old and 48.9% (160) ≥65 yo. Elderly patients exhibited more atypical symptoms and ECG changes as compared to younger. Being elderly (p=0.003) and having had medical contact prior to going to the ED (p=0.015) were associated with a longer activation time. Women older than 65 years old showed the longest activation time.

STEMI delays are longer in elderly with atypical presentation. Age ≥65 and first medical contact outside the ED were associated with an increase in the activation time. This highlights the need to develop strategies to improve STEMI activation time for elderly.