Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Tue, Sep 8, 2026
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Volume 40, Issue 1 (1-2026)
Med J Islam Repub Iran 2026 |
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Kolivand Z, Azari S, Hasani Sharamin P, Shajari Z, Rouzitalab M, Omidi N et al . Evaluation of Effective Factors in the Prognosis of Patients with Acute Myocardial Infarction Transferred by Emergency Medical Services and Self-Referred Patients in Tehran. Med J Islam Repub Iran 2026; 40 (1) :689-698
URL: http://mjiri.iums.ac.ir/article-1-9435-en.html
URL: http://mjiri.iums.ac.ir/article-1-9435-en.html
Zahra Kolivand 
, Samad Azari , Parisa Hasani Sharamin , Zahra Shajari , Mostafa Rouzitalab , Negar Omidi , Peyman Saberian
, Samad Azari , Parisa Hasani Sharamin , Zahra Shajari , Mostafa Rouzitalab , Negar Omidi , Peyman Saberian
Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran , pymnsbrin82@gmail.com
Abstract: (204 Views)
Background: Little is known about the current scenario of acute myocardial infarction (AMI) under primary angioplasty; Transferred by emergency medical services and self-referred patients in Iran.
Methods: The study population consisted of AMI patients with ST-segment elevation myocardial infarction (STEMI) who were consecutively admitted with Emergency Medical Services (EMS) or directly in the first six months of 2021 in 2 PCI-capable selected hospitals in Tehran. We analyzed the pattern of transfer by emergency medical services and compared in-hospital treatments and outcomes between transferred patients and self-referred patients in Tehran. Statistical comparisons were performed using chi‑square, t‑tests, or Mann–Whitney U tests, and multivariable logistic regression was used to assess factors associated with in‑hospital mortality, with significance set at P<0.05.
Results: In-hospital mortality was higher in the self-referred than in patients transferred by EMS (9.8% versus 5.2%) (P=0.014). The average door-to-balloon (DTB) time in the self-referred patients was significantly higher (60.26±59.0 minutes vs 49.30±48.82 minutes) (P=0.020). Results show that the average DTB time of patients who died in the hospital was higher than that of patients who were alive in the self-referred patients. The average time from pain onset to Balloon (OTB) in the self-referred patients and those transferred by EMS was 348.74±316.07 minutes and 226.26±183.15 minutes, respectively (P<0.001). Multivariable logistic regression models the chance of in-hospital mortality in patients who self-referred is 2.17 times that of patients who were transferred by EMS, which is statistically significant (P=0.008).
Conclusion: Our results indicated that there are significant differences in treatment delay and use of early revascularization, such as time of first medical contact (FMC) to the device, time of pain onset to Balloon (OTB), and DTB time between transferred-by-EMS patients and self-referred patients.
Methods: The study population consisted of AMI patients with ST-segment elevation myocardial infarction (STEMI) who were consecutively admitted with Emergency Medical Services (EMS) or directly in the first six months of 2021 in 2 PCI-capable selected hospitals in Tehran. We analyzed the pattern of transfer by emergency medical services and compared in-hospital treatments and outcomes between transferred patients and self-referred patients in Tehran. Statistical comparisons were performed using chi‑square, t‑tests, or Mann–Whitney U tests, and multivariable logistic regression was used to assess factors associated with in‑hospital mortality, with significance set at P<0.05.
Results: In-hospital mortality was higher in the self-referred than in patients transferred by EMS (9.8% versus 5.2%) (P=0.014). The average door-to-balloon (DTB) time in the self-referred patients was significantly higher (60.26±59.0 minutes vs 49.30±48.82 minutes) (P=0.020). Results show that the average DTB time of patients who died in the hospital was higher than that of patients who were alive in the self-referred patients. The average time from pain onset to Balloon (OTB) in the self-referred patients and those transferred by EMS was 348.74±316.07 minutes and 226.26±183.15 minutes, respectively (P<0.001). Multivariable logistic regression models the chance of in-hospital mortality in patients who self-referred is 2.17 times that of patients who were transferred by EMS, which is statistically significant (P=0.008).
Conclusion: Our results indicated that there are significant differences in treatment delay and use of early revascularization, such as time of first medical contact (FMC) to the device, time of pain onset to Balloon (OTB), and DTB time between transferred-by-EMS patients and self-referred patients.
: Original Research |
Subject:
Cardiovascular
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