The Role of STEMI Communication Network in Malang with Major Adverse Cardiac Event (MACE) Incidence in STEMI Patients Hospitalized in Saiful Anwar General Hospital Malang

Adhika Prastya Wikananda, Lenny Kartika, Dadang Hendrawan, Heny Martini, Mohammad Saifur Rohman


Background: Patient with STEMI requires urgent reperfusion either with fibrinolytic or primary PCI. In Malang, a communication network of STEMI has been developed. It connects Saiful Anwar General Hospital with all of the PHC in Greater Malang to shorten system delay since 2015.

Objective: To elucidate Malang’s communication network’s role in decreasing MACE (Major Adverse Cardiac Event) in STEMI patients.

Methods : This is a retrospective cohort study. Study sample was taken from medical record. Non-network: 96 patients and 88 network patients. Statistical tests using SPSS and PLS, α value 0.05 and t-test is significant if more than 1.96.

Results: Bivariate analysis shows network-group has a significantly lower MACE (p=0.001). Door-to-balloon time is also lower in network-group (p=0.026). Multivariate analysis without confounder shows that network-group has significantly shorter door-to-reperfusion time (p=0.032) and lower MACE (p=0.035) compared to non-network group. But multivariate analysis with confounder door-to-balloon and door-to-needle fails to explain lower MACE incidence. Network-group (p=0.005) and reperfusion with primary PCI (p=0.05) significantly decrease MACE incidence.

Conclusion: Malang’s STEMI communication network and reperfusion with primary PCI reduce MACE in STEMI patients in Saiful Anwar General Hospital Malang.


STEMI, reperfusion network, MACE

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