CODE STEMI Program Improves Clinical Outcome in ST Elevation Myocardial Infarction Patients: A Retrospective Cohort Study

Figures & data

Figure 1 CODE STEMI protocol in Cipto Mangunkusumo Hospital. Step-by-step process of STEMI management. Once the CODE STEMI is activated, physician alert the interventional cardiologist, cardiac catheterization laboratory team, and administrative staff simultaneously to hasten the preparation of primary percutaneous intervention.

Abbreviations: ECG, electrocardiogram; ED, emergency department; PCI, primary cutaneous intervention; STEMI, ST elevation myocardial infarction.

Table 1 Baseline Characteristics of the Patients

Characteristics	CODE STEMI (N=135)	Pre CODE STEMI (N=72)	P value
Sex, n (%)			0.75
Male	116 (85.9)	63 (87.5)
Female	19 (14.1)	9 (12.5)
Age	56.1	59.7	0.031
Risk Factor	55 (40.7)	34 (47.2)	0.3696
Diabetes Mellitus, n (%)
Hypertension, n (%)	74 (54.81)	41 (56.94)	0.7690
Dyslipidemia, n (%)	51 (37.8)	24 (33.3)	0.526
Obesity, n (%)	9 (6.7)	2 (28)	0.2348
Acute Kidney Injury, n (%)	23 (17.0)	16 (22.5)	0.3384
Chronic Kidney Disease, n (%)	18 (13.43)	22 (30.56)	0.0031
GRACE Score, n (%)			0.944
Severe	4 (21.05)	3 (18.92)
Moderate	3 (15.79)	3 (16.22)
Mild	12 (63.16)	12 (66.67)
Onset, n (%)			0.631
>6 hours	22 (16)	55 (76.3)
≤6 hours	23 (17)	68 (94)

Figure 2 Door to balloon time trend in STEMI patients by year.

Table 2 Data Analysis: MACE and Mortality

	CODE STEMI n = 135	Pre CODE STEMI n = 72	RR (95% CI)
MACE	51 (37.78%)	35 (48.61%)	0.777 (0.564–1.071)
Mortality	6 (4.44%)	6 (8.33%)	0.533 (0.178–1.593)

Abbreviations: CI, confidence Interval; D2BT, door to balloon time; MACE, major adverse cardiovascular events; RR, risk ratio.

Table 3 Data Analysis: Door to Balloon Time, Total Hospital Cost, Length of Stay

Variable	CODE STEMI n = 135	Pre CODE STEMI n = 72	P
D2BT, minutes (minimum–maximum)	158 (66–640)	288 (120–1376)	<0.001
Total hospital cost, USD (minimum–maximum)	3818.95 (543.03–12,172.11)	4870.97 (1690.55–16,828.63)	<0.001
Length of stay, days (minimum–maximum)	6 (2–34)	7 (2–24)	0.009

Abbreviations: D2BT, door to balloon time; USD, US dollar.