Martin Studenčan
Since 2007, the most important source of information on STEMI (and ACS as such) patient management in Slovakia
has been the SLOVAKS register, which is administered by the Slovak Society of Cardiology. In 2015, the latest
periodic survey of the SLOVAKS register was carried out in Slovakia. This survey focused on the management
of 1,704 ACS patients, with the STEMI patients share representing 32.5 %. Another 1.6 % of patients had LBBB
on ECG. In the STEMI category, primary reperfusion treatment was performed in 73 % of patients (pPCI 70.7 %,
thrombolysis 2.34 %). The median of the total ischaemic time was 230.5 minutes. Up to 36.6 % of all pPCIs were
performed out of the recommended maximum time interval (within 120 min of ECG diagnosis) and 65 % out of the
recommended optimal time interval (within 90 min of ECG diagnosis). The main reasons for avoidable time delay
were hesitation of patients (median of symptoms-to-ECG interval: 110 min) and transportation of patients, since up
to 35 % of STEMI patients were admitted to pPCI centres via secondary transportation. Hospital mortality of STEMI
patients was 5.77 %. Since 2017, under the auspices of the Ministry of Health of the Slovak Republic, a nation-wide
communication technology has been deployed in Slovakia providing, based on the 24/7 telemedicine principles,
an instant voice and visual (ECG) consultation between a field rescuer and a cardiologist in a cardiology centre.
According to the results of the pilot project, the above technology has a significant potential to reduce the proportion
of unwanted secondary patient transportation and, in particular, reduce the overall ischemic interval in STEMI
patients, which can affect the patient prognosis. The challenge for health care professionals is the introduction, or
re-introduction, of pre-hospital thrombolytic treatment in patients who do not meet the criteria for performing pPCI
within the recommended time limit.