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Clinical significance of prehospital 12-lead electrocardiography in patients with ST-segment elevation myocardial infarction presenting with syncope: from a multicenter observational registry (K-ACTIVE study)

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Abstract

Patients with acute myocardial infarction (AMI) presenting with syncope have poor clinical outcomes partly due to a delay in the diagnosis. Although the impact of prehospital 12-lead electrocardiography (PHECG) on the reduction of first medical contact (FMC)-to-device time and subsequent adverse clinical events in patients with AMI has been demonstrated, the impact of PHECG for the patients presenting with syncope remains to be elucidated. This study aimed to explore the impact of PHECG on 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI) presenting with syncope. From a cohort of multi-center registry [Kanagawa-ACuTe cardIoVascular rEgistry (K-ACTIVE)], a total of 90 consecutive patients with STEMI presenting with syncope were included. The 30-day mortality were compared between patients with PHECG (PHECG group, n = 25) and those without PHECG (non-PHECG group, n = 65). There was no significant difference in the baseline clinical characteristics between the 2 groups. FMC-to-device time was significantly shorter in the PHECG group than in the non-PHECG group (122 [86, 128] vs. 131 [102, 153] min, p = 0.03) due to the shorter door-to-device time. Thirty-day mortality was significantly lower in the PHECG group than in the non-PHECG group (16.0 vs. 44.6%, p = 0.03). In conclusion, PHECG was associated with shorter FMC-to-device time and lower 30-day mortality in patients with STEMI presenting with syncope.

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Acknowledgements

We thank Dr. Hiroki Nishiwaki and Assistant Professor Takenori Yamauchi for their valuable suggestions on the manuscript.

Funding

This work was supported by JSPS KAKENHI (Grant Number JP15K09101).

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kitasato University Hospital, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0375, Japan

    Nobuhiro Sato, Yoshiyasu Minami & Junya Ako

  2. Showa University Fujigaoka Hospital, Yokohama, Japan

    Atsuo Maeda & Hiroshi Suzuki

  3. St. Mariannna University School of Medicine, Kawasaki, Japan

    Yoshihiro Akashi

  4. Tokai University School of Medicine, Isehara, Japan

    Yuji Ikari

  5. Yokohama City University Medical Center, Yokohama, Japan

    Toshiaki Ebina & Kazuo Kimura

  6. Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Kouichi Tamura

  7. Kanto Rosai Hospital, Kawasaki, Japan

    Atsuo Namiki

  8. Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan

    Kazuki Fukui

  9. Yokohama Sakae Kyosai Hospital, Yokohama, Japan

    Ichiro Michishita

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  1. Nobuhiro Sato
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  2. Yoshiyasu Minami
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  13. Hiroshi Suzuki
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Correspondence to Yoshiyasu Minami.

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Conflict of interest

Yoshihiro Akashi received lecture fee from Daiichi-Sankyo Co. Ltd (Tokyo, japan) and scholarship funds from Medtronic Japan Co., Ltd. (Tokyo, japan); Abbott Japan Co., Ltd. (Tokyo, japan); Nihon Medi-Physics Co., Ltd. (Tokyo, japan); FUJIFILM Toyama Chemical Co., Ltd. (Tokyo, japan); MC Co., Ltd (Tokyo, japan).

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This work was approved by the Human Research Committee of Kitasato University School of Medicine (B 15-110).

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Sato, N., Minami, Y., Ako, J. et al. Clinical significance of prehospital 12-lead electrocardiography in patients with ST-segment elevation myocardial infarction presenting with syncope: from a multicenter observational registry (K-ACTIVE study). Heart Vessels 36, 1466–1473 (2021). https://doi.org/10.1007/s00380-021-01832-z

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