Abstract 18419: Evolution of a Regional STEMI Reperfusion Model: More and Earlier Reperfusion but No Improvement in Clinical Outcomes

Introduction: Guidelines strongly recommend that regional systems of STEMI care include the assessment and continuous quality improvement of emergency medical services and hospital-based activities. Hypothesis: Within a mixed reperfusion model of STEMI care, the introduction of individual care components will improve reperfusion times and clinical outcomes. Methods: All patients with confirmed STEMI presenting within the Vancouver Coastal Health Authority from June 2007 to September 2013 were included (n = 2041). Primary analysis was performed by care component phase: Phase 1, regionalization of the STEMI program (n = 278, June 2007 to May 2008); Phase 2, introduction of pre-hospital ECGs (n = 979, May 2008 to May 2011); and Phase 3, implementation of an inter-facility transfer protocol for primary PCI (pPCI) (n = 784, May 2011 to September 2013). Secondary analysis compared PCI capable vs. PCI non-capable hospitals. Results: Clinical characteristics were similar across phases. Median first medical contac...