The Impact of Transportation Mode on ST-Segment Elevation Myocardial Infarction (STEMI) Reperfusion Time and Survival

BACKGROUND: Acute coronary syndrome continues to be the leading cause of mortality worldwide, making it crucial to achieve a door-to-balloon (D2B) time under 90 minutes to enhance patient outcomes. This study aims to evaluate how outcomes differ between patients who arrive via emergency medical services (EMS) and those who arrive via self-transport. METHODS: This was a retrospective study conducted at a tertiary hospital in the eastern province of Saudi Arabia. The study included both Saudi and non-Saudi patients who presented to the emergency department (ED) between March 1, 2022, and November 11, 2024, with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) requiring primary percutaneous coronary intervention (PCI). Patients were divided into two groups based on their mode of transport. Collected data include age, gender, nationality, D2B and door-to-electrocardiogram (ECG) times, smoking status, chronic conditions, and peak troponin levels. RESULTS: A total of 204 STEMI and NSTEMI infarction cases were included in this study. Most cases (172, 84.3%) arrived via self-transport, while 32 (15.7%) arrived via EMS. The EMS group demonstrated significantly shorter median times for both door-to-ECG time (3 minutes vs. 5.5 minutes; p