Median time to first aspirin dose, among ideal patients who received aspirin within 24 hours, improved from 105 minutes at baseline to only 55 minutes on impact. Patients with evolving acute MI should receive early intravenous adrenergic blocker therapy. Because the time from onset of infarction cannot be reliably assessed for all patients, twelve hours from arrival at the Emergency Department was used. In addition, the median time to beta blockers among those receiving them within 12 hours decreased from 4.2 to 3.6 hours for ideal patients. A powerful time dependent effect on mortality has been observed in the administration of thrombolytic agents.
Many hospitals have a target of thirty minutes to initial reperfusion.
A table of statewide results for all indicators is attached to this report. Although substantial improvements were made between 1996 and 1998, further improvement in AMI care can still be achieved. IPRO will continue to work with New York hospitals to optimize care as part of the National AMI project, which will run from 1999 through 2002.