ABC | Volume 112, Nº4, April 2019

Original Article Balk et al Transfer time in STEMI patients Arq Bras Cardiol. 2019; 112(4):402-407 1. Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acutemyocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361(9351):13-20. 2. Pinto DS, Kirtane AJ, Nallamothu BK, Murphy SA, Cohen DJ, Laham RJ, et al. Hospital delays in reperfusion for ST-elevation myocardial infarction: implications when selecting a reperfusion strategy. Circulation. 2006;114(19):2019-25. 3. Gibson CM. Time is myocardium and time is outcomes. Circulation. 2001;104(22):2632-4 4. Nielsen PH, Terkelsen CJ, Nielsen TT, Thuesen L, Krusell LR, Thayssen P, et al. System delay and timing of intervention in acute myocardial infarction (from the Danish Acute Myocardial Infarction-2 [DANAMI-2] trial). Am J Cardiol. 2011;108(6):776-81. 5. Sorensen JT, Terkelsen CJ, Norgaard BL, Trautner S, Hansen TM, Botker HE, et al. 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De Luca G, Suryapranata H, Ottervanger JP, Antman EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction: everyminute of delay counts. Circulation. 2004;109(10):1223-5. 13. Andersen HR, Nielsen TT, Rasmussen K, Thuesen L, Kelbaek H, Thayssen P, et al. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med. 2003;349(8):733-42. 14. Pinto DS, Frederick PD, Chakrabarti AK, Kirtane AJ, Ullman E, Dejam A, et al. Benefit of transferring ST-segment-elevation myocardial infarction patients for percutaneous coronary intervention compared with administration of onsite fibrinolytic declines as delays increase. Circulation. 2011;124(23):2512-21. 15. Nallamothu B, Fox KA, Kennelly BM, Van de Werf F, Gore JM, Steg PG, et al. Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events. Heart. 2007;93(12):1552-5. 16. Widimsky P, Budesinsky T, Vorac D, Groch L, Zelizko M, Aschermann M, et al. Long distance transport for primary angioplasty vs immediate thrombolysis in acutemyocardial infarction. Final results of the randomized national multicentre trial--PRAGUE-2. Eur Heart J. 2003;24(1):94-104. 17. Cardoso CO, Quadros AS, Voltolini I, Azmus AD, Cardoso CR, Sebben J, et al. Angioplastia primária no infarto agudo do miocárdio: existe diferença de resultados entre as angioplastias realizadas dentro e fora do horário de rotina? Rev Bras Cardiol Invasiva. 2010;18(3):273-80. References Conclusion The present study shows that AMI patients transferred from other institutions have prolonged ischemic time, exceeding that recommended by the Brazilians guidelines. However, ischemic time varied largely between the cities, in a direct proportion to the distance covered. These findings can help health managers in identifying how to improve patient transport system, leading to earlier reperfusion therapy and mortality reduction. Author contributions Conception and design of the research: Balk M. Acquisition of data: Balk M, Gomes HB. Statistical analysis: Saffi MAL, Leiria TLL. Writing of the manuscript: Saffi MAL, Leiria TLL. Critical revision of the manuscript for intellectual content: Gomes HB, Quadros AS, Leiria TLL. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This study is not associatedwith any thesis or dissertationwork. Ethics approval and consent to participate This study was approved by the Ethics Committee of the Instituto de Cardiologia - Fundação Universitária de Cardiologia (IC/FUC), under the protocol number 5565/18. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 406