Outcome of primary angioplasty for XXXX during routine duty hours versus during off-hours.

@entity1 @entity583 @entity661
OBJECTIVES: We sought to investigate the impact of circadian patterns in the onset of @entity583 ( @entity583 ) on the practice of primary angioplasty. BACKGROUND: A circadian variation in the time of onset of @entity583 with a peak in the morning hours has been described. METHODS: We studied 1,702 consecutive @entity1 with acute ST-segment elevation @entity583 treated with primary angioplasty. We observed circadian variation in frequency of symptom onset, hospital admission, and @entity661 . Circadian patterns of symptom onset, hospital admission, and balloon inflation are similar. RESULTS: A majority of @entity1 have symptom onset (53%), hospital admission (53%), and @entity661 (52%) during routine duty hours (0800 to 1800 h). There were no differences in baseline clinical characteristics or treatment delays between routine duty hours and off-hours @entity1 . Hospital admission between 0800 and 1800 was associated with an angioplasty failure rate of 3.8%, compared with 6.9% between 1800 and 0800, p < 0.01. Thirty-day mortality was 1.9% in @entity1 with hospital admission between 0800 and 1800, compared with 4.2% in @entity1 with hospital admission between 1800 and 0800, p < 0.01. CONCLUSIONS: Circadian variations may have a profound effect on the practice of primary angioplasty. A majority of @entity1 are treated during routine duty hours. @entity1 treated during off-hours have a higher incidence of failed angioplasty and consequently a worse clinical outcome than @entity1 treated during routine duty hours.
