| Contributors: |
Colaiori, I.; Biondi-Zoccai, G.; Spadafora, L.; Bernardi, M.; Aloia, A.; Ancona, M.; Aprigliano, G.; Barbato, E.; Baldi, C.; Briguori, C.; Buja, P.; Cadeddu, M.; Casu, G.; De Caterina, A.; De Felice, F.; De Simone, C.; Donazzan, L.; Ferranti, F.; Franco, N.; Gaspardone, A.; Hiso, E.; Leoncini, M.; Leone, A.; Lucreziotti, S.; Mancone, M.; Marinucci, L.; Maioli, M.; Montorfano, M.; Musaro, S.; Niglio, T.; Picchi, A.; Poli, A.; Preti, G.; Ribichini, F. L.; Rolandi, A.; Romagnoli, E.; Sangiorgi, G. M.; Serino, F.; Solda, P.; Tiberti, G.; Tomai, F.; Tomassini, F.; Ugo, F.; Esposito, G.; Saia, F.; Versaci, F. |
| Description: |
BACKGROUND: Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics. METHODS: A prospective observational study conducted from September 1st to 25th, 2023, including 554 STEMI patients treated at high-volume hub centers operating 24/7. Data were collected through structured surveys completed by catheterization laboratory directors across different Italian regions. Primary outcomes included door-to-balloon (DTB) time, time from symptom onset to balloon inflation, and regional disparities in pre- and post-PCI management. Secondary outcomes included in-hospital mortality, discharge destinations, and medication regimens. RESULTS: The median DTB time was consistent across regions (30 minutes; IQR: 20-50 minutes). Significant regional disparities were however noted in time from symptom onset to balloon inflation, with Southern and Island regions experiencing longer median times (180 minutes) compared to Central (170 minutes) and Northern (154 minutes) regions (P |