External validation of the prediction time from the first medical contact until the artery’s opening

Abstract

Background: Ischemic heart disease remains the most important cause of mortality, morbidity and hospitalization in the world. When acute myocardial infarction occurs, the opening time of the clogged artery is essential to reduce the degree of myocardial necrosis. For this reason, European Cardiology Guidelines advise coronary opening treatment as soon as possible. The current recommendation is to prioritize primary angioplasty over fibrinolysis, as it is more effective and safer. However, in the same way, that an early angioplasty is more effective than early fibrinolysis, this superiority disappears when angioplasty is late. Because of this, the guidelines recommend "calculating" the ideal time until primary angioplasty and, if it exceeds 120 minutes, opt for fibrinolytic treatment in patients who do not have contraindications. The cardiology service of the Dr. Josep Trueta University Hospital has been working on this prediction model for years. Finally, and based on data from 2.000 patients, it has been possible to create a linear prediction model from the first medical contact until the opening of the artery with primary angioplasty. An internal validation has been implemented satisfactory and is currently being published. Objective: Externally validate, in the towns of Lleida and Tarragona, the prediction function of time from the first medical contact to the opening of the artery (primary angioplasty time) obtained with the sample data of the Dr. Josep Trueta University Hospital. Methodology: A multicentre, retrospective cohorts study will be carried out from 2007 to 2018; with the data registered in Arnau de Vilanova University Hospital and Joan XXIII University Hospital. Variables related to the patient, the heart attack and the transfer to the centre with hemodynamics will be recollected. The sample will be included in a validation set for the validation of the predictive score