Prognostic Impact of the Presence of On-Duty Cardiologist on Patients with Acute Myocardial Infarction Admitted During Off-Hours – DocWire News

BACKGROUND:

Owing to reduced staffing, patients hospitalized for acutemyocardial infarction(AMI) during off-hours (nights, weekends, and holidays) have poorer outcomes than those admitted during regular hours. Whether the presence of an on-duty cardiologist in a hospital during off-hours is related to better outcomes for patients with AMI remains unclear. The Miyazaki Prefectural Nobeoka Hospital had a unique medical care system in that cardiologists were on call for half of the week and on duty for the other half during off-hours, thus providing an opportunity to assess the relationship between the presence of an on-duty cardiologist and patient outcomes. We examined clinical outcomes of patients admitted for AMI during off-hours according to the presence of an on-duty cardiologist.

We recruited 225 consecutive patients with AMI hospitalized during off-hours, who underwent stent implantation at Miyazaki Prefecture Nobeoka Hospital from 2013 to 2017. The endpoints were in-hospital death or long-term major adverse cardiac events (MACE) including cardiovascular death, non-fatal MI, non-fatal stroke, stent thrombosis, ischemia-driven target-lesion revascularization, admission owing to unstable angina, or admission owing to heart failure.

Based on the presence of an on-call cardiologist at admission, we divided patients into the cardiologist on-call group (n=112) or cardiologist on-duty group (n=113). The presence of an on-duty cardiologist did not affect door-to-reperfusion time (p=0.776), level of peak creatine kinase (p=0.971), or in-hospital death (p=0.776). The Kaplan-Meier curve analysis showed similar prognosis for the cardiologist on-duty and cardiologist on-call groups (p=0.843), and multivariable Cox regression analysis showed that the presence of an on-duty cardiologist was not associated with MACE.

The presence of an on-duty cardiologist is not a prognostic factor for patients hospitalized for AMI during off-hours in our medical system. Further prospective multicenter studies should confirm our results.

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Prognostic Impact of the Presence of On-Duty Cardiologist on Patients with Acute Myocardial Infarction Admitted During Off-Hours - DocWire News