Impact of Off-Hour Versus Work-Hour Presentation on Clinical Outcomes in Acute STEMI Patients Treated With Primary PCI: A Retrospective Analysis

Authors : Engin Özakın
Pages : 126-132
Doi:10.20515/otd.1775465
View : 32 | Download : 91
Publication Date : 2025-12-15
Article Type : Research Paper
Abstract :For patients with ST-segment elevation myocardial infarction (STEMI), optimal reperfusion timing is crucial for positive outcomes. The existence of treatment delays or disparities in outcomes for off-hours presentations is still debated. This study examined how the timing of hospital presentation (working hours vs. off-hours) affects procedural efficiency and early clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). This retrospective, single-center study examined 186 consecutive adult STEMI patients who were treated with primary PCI between January and December 2023. Patients were divided into two groups based on their time of admission: working hours (8:00 a.m.–5:00 p.m. on weekdays; n = 54) and off-hours (5:00 p.m.–8:00 a.m. on weekends and holidays; n = 132). Door-to-balloon time (DTB), PCI duration, left ventricular ejection fraction (EF), length of stay (LOS) and in-hospital mortality were compared. DTB ≤ 60 minutes was achieved in 86.1% of all patients, with no difference between the two groups (working vs. off-hours: 87.0% vs. 85.6%; p=0.909). However, the duration of PCI was significantly longer during off-hours (43.00 ± 24.87 minutes vs. 32.13 ± 17.05 minutes; p = 0.001). There were no statistically significant differences in in-hospital mortality (6.82% vs. 7.41%; p = 1.000), ejection fraction (EF), or length of stay (LOS). Despite the longer PCI times during off-hours, the early clinical outcomes were equivalent to those during working hours. This underscores the importance of dedicated 24/7 STEMI protocols with robust PCI infrastructure in providing consistent, high-quality care regardless of admission time. Streamlining off-hours workflows could further optimize procedural efficiency within emergency cardiovascular systems.
Keywords : ST segment yükselmesi miyokard enfarktüsü, primer PCI, mesai dışı saatler, kapı-balon zamanı

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