2022 Quality Summit ePosters (Non-CE) - Chest Pain-MI Registry-3. Early Invasive Strategy in Patients with High-Risk Non-ST Segment Elevation Myocardial Infarction: Delays, Barriers, and Impacts at a Tertiary Medical Center.

3. Early Invasive Strategy in Patients with High-Risk Non-ST Segment Elevation Myocardial Infarction: Delays, Barriers, and Impacts at a Tertiary Medical Center.

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The study explored the limitations and barriers to implementing an early invasive strategy (EIS) for high-risk non-ST segment elevation myocardial infarction (NSTEMI) patients at a tertiary medical center. The authors found that a significant percentage of high-risk NSTEMI patients were not receiving EIS at their institution. They also did not find a statistical difference in patients receiving EIS based on prospective risk stratification. Factors such as older age, female gender, delays in first troponin draw, and completion of cardiology consultation seemed to correlate with delayed implementation of EIS.<br /><br />The authors proposed several future investigations and interventions to improve the implementation of EIS for high-risk NSTEMI patients. They suggested leveraging electronic medical records to automate a TIMI Risk Score and provide clinicians with a rapid tool for triaging NSTEMI patients. They also recommended coordinating electronic push notifications to expedite high-risk NSTEMI patients to the cardiac catheterization lab. Additionally, the authors emphasized the importance of collaborating and streamlining EIS protocols with transferring facilities.<br /><br />The study referenced the NCDR® CP-MI executive dashboards and the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain.<br /><br />The table provided in the document presents the baseline characteristics of the study groups, including age, gender, race, health insurance, HEART score, TIMI score, peak pre-procedure troponin level, consult time to completion, arrival to first troponin draw, arrival to cath lab, initial creatinine level, and use of anticoagulation.<br /><br />In conclusion, the study highlighted the limitations, delays, and barriers to implementing EIS for high-risk NSTEMI patients. The authors suggested potential interventions and future investigations to improve the timely implementation of EIS.

Keywords

limitations

barriers

implementing

early invasive strategy

high-risk

NSTEMI

prospective risk stratification

electronic medical records

cardiac catheterization lab

EIS protocols