Medical emergency team interventions in patients with ST-segment elevation myocardial infarction in Poland in 2018

BACKGROUND The National Emergency Medical Services Management Support System, a unique information and communication technology system, was developed to reduce the burden of ST-segment elevation myocardial infarction (STEMI) in Poland. According to the European Society of Cardiology guidelines, medical emergency teams (METs)should diagnose STEMI using electrocardiogram (ECG) transmission and apply dual antiplatelet therapy (DAPT) as a pivotal treatment. AIMS This study aimed to analyze MET interventions in patients with STEMI and assess regional differences in the management in Poland. METHODS Using ambulance call reports, we retrospectively analyzed MET interventions due to conditions classified as 121 (acute myocardial infarction; according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision), which were performed in Poland between January 1, 2018 and December 31, 2018. RESULTS In 2018, METs conducted 16 807 interventions classified as I21, which accounted for 0.5% of all MET interventions in Poland in that year. Most interventions were conducted in the Mazovia Province (13.4%; P <0.001), and the lowest number was reported in the Podlasie Province (2.5%). A 12-lead ECG was performed during 98.6% of interventions, and ECG transmission in 37.49%: most often in the Mazovia Province (59.62%; P <0.001), and least often in the Lublin Province (13.8%). In 72.12% of interventions, DAPT was applied: clopidogrel was the P2Y12 inhibitor used in 49.68% of interventions, and ticagrelor in 25.14% (P <0.001). A P2Y12 inhibitor was most often used in the Wielkopolska Province (98.4%), and least often in the Silesia Province (40.34%). CONCLUSIONS Significant differences in the implementation of the European Society of Cardiology guidelines regarding ECG transmission and DAPT were observed between particular provinces in Poland.