Transmission of 12-leads electrocardiogram from ambulances decreases patient complications of ST segment elevation myocardial infarction by reducing door-to-reperfusion time

Background Recently, our hospital has obtained prehospital 12-lead electrocardiograms (ECGs) from ambulances. We examined the extent to which these 12-lead ECG transmissions shortened DTBT and improved prognosis. Methods From January 1, 2016, to August 14, 2025, 487 patients presented to our hospital within 12 hours after chest pain onset and were diagnosed with ST-segment elevation myocardial infarction. Among these cases, those who came in as walk-ins and those referred from local physicians were excluded from this study due to their different backgrounds and their prolonged total ischemia time. Patients were divided into two groups to compare the DTBT and subsequent outcomes: the group without ECG transmission and the group with ECG transmission. Major adverse events were defined as in-hospital or out-of-hospital death and heart failure following treatment, and data were collected. Results DTBT was significantly shorter in the ECG transmission group than in the no ECG transmission group, reflecting significantly shorter door-to-catheterization laboratory time (ECG transmission 44min, without transmission 66min, p < 0.01). Reflecting this, fewer major adverse cardiovascular events (MACE) were observed in the ECG transmission group than in the non-transmission group. Multivariate analysis showed that ECG transmission contributed to the achievement of DTBT within 60 minutes, and multivariate analysis showed that only Killip 2 degrees or greater significantly increased the incidence of MACE, but ECG transmission also tended to reduce it (Odds ratio 0.42, p = 0.05). Conclusions For patients who are aware of chest pain and present directly to the emergency department by ambulance, the 12-lead ECG transmission results obtained via this route may reduce patient complications.