[Role of prehospital electrocardiogram in the early diagnosis of XXXX ].

@entity1 @entity63 @entity1397 @entity117 @entity583
In @entity1 with @entity583 ( @entity583 ), fast reperfusion is associated with reduced morbidity and mortality. Many @entity1 , however, do not meet the recommended standard times. Among the strategies considered to accomplish this task, prehospital ECG (PH-ECG) is advocated by international guidelines. International and Italian regional registries demonstrate the efficacy of PH-ECG to reduce both @entity63 and first medical contact-to-balloon times in @entity583 @entity1 treated with primary angioplasty. Despite the available evidence, PH-ECG is still underused in the real world, without showing any significant increase in recent years. According to the LombardIMA registry, only 12% of the total population had a PH-ECG; in these @entity1 median @entity63 time was 154 vs 208 min when PH-ECG was not available. Median first medical contact-to-balloon time was 50 and 85 min, respectively. The use of PH-ECG showed also a trend for lower 30-day mortality, though not statistically significant. PH-ECG can also lead to early antithrombotic therapy ( @entity117 , @entity1397 or IIb/IIIa inhibitors), which is associated with better angiographic outcome. Data from the LombardIMA registry show that PH-ECG may play a relevant role in the management of @entity583 networks, with less @entity1 admitted to hospital without on-site cath-lab and reduced reperfusion delays in @entity1 transferred from spoke to hub hospitals.
