2008 Faculty Researchers

Dmitri Baklanov M.D., Ph.D.

Department

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Summary

In 2004 in the U.S. the odds for dying from a plane crash were 1 in 432484, from coronary heart disease 1 in 5 [1] [2]. Every airline passenger is offered a 3 minute educational intervention in preparation of an emergency, whereas there is no widely accepted training of patients at risk for STEMI. The ACC/AHA Guidelines for the management of patients with ST elevation myocardial infarction provide summary of the strong evidence that faster times to myocardial reperfusion and better systems of care are associated with important reductions in morbidity and mortality rates in patients with STEMI. [3]. The medical system goal is to facilitate rapid recognition and treatment of patients with STEMI so that door-to-needle (or medical contact-to-needle) for initiation of fibrinolytic therapy can be achieved within 30 minutes or door-to-balloon (or medical contact-to-balloon) for PCI can be achieved within 90 minutes. These goals are not understood as "ideal" times but rather the longest times that should be considered acceptable for a given system. Systems that are able to achieve even more rapid times for treatment of patients with STEMI are encouraged. It is recognized that most delays in STEMI care occur in prehospital setting. It is not known if patients themselves can contribute to such systems and if a community-based targeted education of adults at risk for STEMI can improve medical contact to intervention times.

Potential Hypotheses

1. Patients with high risk for STEMI will have better knowledge about their expected actions in case of a flight emergency as opposed to signs and symptoms of STEMI.
2. minute education intervention in the group setting will improve their performance on a standard 5 question test regarding the symptoms of acute MI and the best course of action.
3. Targeted education of adults with myocardium at risk will improve the rate of initiation of reperfusion therapy administered within the first hour (“Golden Hour”) of STEMI.

Methods

MU Diabetes Center patients over the age of 35 will be offered participation in a small group education session. In the beginning of the session, a standard multiple choice questionnaire will be administered, followed by the oral education intervention by an investigator. The test will be repeated and improvement in the test score compared.

1. Odds of Death Due to Injury, United States, 2004. National Safety Council 2007 [cited; Available from: http://www.nsc.org/lrs/statinfo/odds.htm.
2. Rosamond, W., et al., Heart Disease and Stroke Statistics 2008 Update. A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2007.
3. Antman, E.M., et al., 2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: developed in collaboration With the Canadian Cardiovascular Society endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee. Circulation, 2008. 117(2): p. 296-329.