The impact of the ambulance with the physician (the Doctor Car) to the primary percutaneous coronary intervention for the ST-elevation myocardial infarction
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Objective: The objective of this study was to estimate the impact of the ambulance with physician (the Doctor Car) on the performance of primary percutaneous coronary intervention (PCI) carried out for ST-elevation myocardial infarction (STEMI). Methods: We retrospectively assessed consecutive 116 patients, who were transferred to our hospital with STEMI and underwent primary PCI from January 2006 to October 2011. Patients were divided into 2 groups: the Doctor Car group (Group D, n=36) and the ordinary transferred group (Group N, n=80). The time taken for transportation and for reperfusion, the procedural aspects of the PCI, and the rate of in-hospital cardiac events were evaluated, and the 2 groups were compared. Results: Although the transportation time was longer in Group D (44±14 min) than Group N (29±11 min) (P<0.01), the arrival-to-reperfusion time (time elapsed from arrival of patient at the hospital to establishment of coronary artery reperfusion) was shorter (76±32 min vs 100±46 min, respectively; P=0.01), and the assisted circulation devices were less frequently used in Group D than in Group N (19% vs 46%, respectively; P=0.01). There was no significant difference between the groups in the rate of in-hospital cardiac events. Conclusions: Although the Doctor Car prolonged the transportation time, it reduced the arrival-to-reperfusion time and the use of the assisted circulation device.