Impact of limitations in access to care in the management of myocardial infarction: epidemiological study from the FRANCE PCI registry

Project summary

CONTEXT

The management of heart attacks with persistent ST segment elevation constitutes a medical and interventional emergency, involving a well-defined chain of care in international recommendations.

This chain of care is structured around three axes. First, education and recognition of the population of the symptoms of heart attack, to alert people as quickly as possible. Second, the pre-hospital care and rescue system to confirm the diagnosis and quickly direct patients to a suitable care structure. Third, coronary angiography centers distributed throughout the territory to quickly unclog the occluded artery. The prognosis of patients is directly correlated to the speed of action of this chain of care.

The growing difficulties of the health system, the lack of resources in medical and paramedical personnel, forces professionals in all sectors to adapt their functioning, often in degraded mode, with insufficient professional staff, and particularly in the Emergency and Emergency teams. pre-hospital SAMU.

These tensions increased at the start of 2023 with many emergency services partially or even completely closed, often to the detriment of the SMUR team in secondary centers which is no longer available to care for the most distant patients. coronary angiography centers.

GOALS

Evaluate on a national scale the impact of current difficulties in the health system on the time taken to treat myocardial infarctions

METHODOLOGY

Comparative analysis of data from the FRANCE PCI registry of patients who were admitted to the coronary angiography room for a coronary syndrome with persistent ST segment elevation, between data from the year 2022 (considered the reference year) and 2023 ( year more impacted by difficulties in healthcare resources).