Sharing primary percutaneous coronary intervention care: first experiences with South Limburg ST-elevation myocardial infarction network

A. Lux*, J. Vainer, R.A.L.J. Theunissen, L.F. Veenstra, I. Kasperski, B.C.G. Gho, M. Stein, M. Ilhan, A.W. Ruiters, P.J.C. Winkler, A. van Beurden, W. Dohmen, S. Rasoul, A.W.J. van 't Hof, South Limburg Interventional Cardiology Group, the Netherlands

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background In the region of South Limburg, the Netherlands, a shared ST-elevation myocardial infarction (STEMI) networking system (SLIM network) was implemented. During out-of-office hours, two percutaneous coronary intervention (PCI) centres-Maastricht University Medical Centre and Zuyderland Medical Centre-are supported by the same interventional cardiologist. The aim of this study was to analyse performance indicators within this network and to compare them with contemporary European Society of Cardiology guidelines. Methods Key time indicators for an all-comer STEMI population were registered by the emergency medical service and the PCI centres. The time measurements showed a non-Gaussian distribution; they are presented as median with 25th and 75th percentiles. Results Between 1 February 2018 and 31 March 2019, a total of 570 STEMI patients were admitted to the participating centres. The total system delay (from emergency call to needle time) was 65 min (53-77), with a prehospital system delay of 40 min (34-47) and a door-to-needle time of 22 min (15-34). Compared with in-office hours, out-of-office hours significantly lengthened system delays (55 (47-66) vs 70 min (62-81), p < 0.001), emergency medical service transport times (29 (24-34) vs 35 min (29-40), p < 0.001) and door-to-needle times (17 (14-26) vs 26 min (18-37), p < 0.001). Conclusions With its effective patient pathway management, the SLIM network was able to meet the quality criteria set by contemporary European revascularisation guidelines.
Original languageEnglish
Pages (from-to)348-353
Number of pages6
JournalNetherlands Heart Journal
Issue number6
Publication statusPublished - Jun 2021


  • delay
  • guidelines
  • impact
  • management
  • mortality
  • primary pci network
  • quality indicator
  • regional care
  • reperfusion
  • task-force
  • time
  • Primary PCI network
  • Regional care
  • TIME
  • Quality indicator

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