The Effect of CODE STEMI on Major Adverse Cardiac Events and Mortality
in ST Elevation Myocardial Infarction Patients at Dr Cipto Mangunkusumo
General Hospital
Abstract
Background : One of the highest causes of cardiac mortality is ST
Elevation Myocardial Infarction (STEMI). Delay in the management of
STEMI patients is a cause of high mortality and morbidity. A CODE STEMI
program is established to help reduce door to balloon time and improve
patient’s care and clinical outcome. Objectives : To determine the
effect of the implementation of CODE STEMI program on Major Adverse
Cardiac Event (MACE) and mortality of STEMI patients at Dr. Cipto
Mangunkusumo General Hospital. Method: This is a retrospective cohort
study that enrolled 207 STEMI patients who underwent primary
percutaneous coronary intervention (PPCI) in 2015-2018. The patients
were divided into two groups. The first group was treated prior to
establishing the CODE STEMI program. The other group was treated
according to the program, which was implemented in January 2017. Data
were collected from medical records and we retrospectively analysed all
in-hours, MACE, and mortality of STEMI patients from both groups. Data
analysis was done using Mann Whitney and Chi square test. Results: There
were 72 and 135 patients in Pre‐CODE STEMI and CODE STEMI groups
respectively. D2BT was significantly reduced by 130 min (288±306 vs
158±81, P< 0.001) since the implementation of CODE STEMI
program. There were trends to lower in-hospital mortality rates (8.3%
vs 4.4%, RR = 0.53) and MACE at 30 days (48.61% vs 37.78%,
RR = 0.77). Conclusion: Implementation of CODE STEMI program can
decrease the risk of MACE and mortality in STEMI patients in general
hospital.