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To the Editor: In their study of the relationship between time of day, timeliness of reperfusion, and in-hospital mortality for patients with acute ST-segment elevation myocardial infarction, Dr Magid and colleagues¹ used data from the United States National Registry of Myocardial Infarction and found that patients presenting during off-hours had higher in-hospital mortality than those presenting during regular hours. Moreover, percutaneous coronary intervention reperfusion times were greater during off-hours than regular hours; this might contribute to higher off-hours in-hospital mortality.

These findings are consistent with other studies conducted in different settings, both in Europe and in the United States. Henriques et al² found that patients treated during off-hours had a higher incidence of failed angioplasty (6.9% vs 3.8%, P<.01) and higher 30-day mortality (4.2% vs 1.9%, P<.01) than patients treated during regular hours. Hospital mortality was also higher in a cohort of patients receiving angioplasty during off-hours than . . . [Full Text of this Article]

Roberto Manfredini, MD
mfr@unife.it

Benedetta Boari, MD; Raffaella Salmi, MD; Anna Maria Malagoni, MD; Fabio Manfredini, MD
Vascular Diseases Center
University of Ferrara
Ferrara, Italy

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