Medical history of coronary artery disease and time to electrocardiogram in the emergency department: a real-life, single-center, retrospective analysis

BMC Cardiovasc Disord. 2021 Oct 7;21(1):480. doi: 10.1186/s12872-021-02274-1.

Abstract

Background: Timely acquisition of 12-lead Electrocardiogram (ECG) in the emergency department (ED) is crucial and recommended by current guidelines.

Objectives: To evaluate the association of medical history of coronary artery disease (hCAD) on door-to-ECG time in the ED.

Methods: In this single center, retrospective cohort study, patients admitted to ED for cardiac evaluation were grouped according to hCAD and no hCAD. The primary outcome was door-to-ECG time. A multivariate analysis adjusted for the cofounders sex, age, type of referral and shift was performed to evaluate the association of hCAD with door-to-ECG time.

Results: 1101 patients were included in this analysis. 362 patients (33%) had hCAD. Patients with hCAD had shorter door-to-ECG time (20 min. [Inter Quartile Range [IQR] 13-30] vs. 22 min. [IQR 14-37]; p < 0.001) when compared to patients with no hCAD. In a multivariable regression analysis hCAD was significantly associated with a shorter door-to-ECG time (- 3 min [p = 0.007; 95% confidence Interval [CI] - 5.16 to - 0.84 min]).

Conclusion: In this single center registry, hCAD was associated with shorter door-to-ECG time. In patients presenting in ED for cardiac evaluation, timely ECG diagnostic should be facilitated irrespective of hCAD.

Keywords: Cardiac Evaluation; Chest pain unit; Coronary artery disease; Door-to-ECG time; Door-to-coronary-angiography; Emergency department.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • After-Hours Care
  • Aged
  • Aged, 80 and over
  • Cardiology Service, Hospital*
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis*
  • Electrocardiography*
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Symptom Assessment*
  • Time Factors
  • Workflow