Reperfusion Delays and Systemic Challenges in ST-Elevation Myocardial Infarction: Insights from a Tertiary Emergency Hospital Registry in Romania
Abstract
Background
Timely reperfusion is the cornerstone of ST-elevation myocardial infarction (STEMI) management. Despite major advances in primary percutaneous coronary intervention (PCI), substantial delays persist, particularly in Eastern Europe.
Methods
We conducted a retrospective, registry-based analysis of 151 consecutive patients with STEMI admitted to a tertiary emergency university hospital in Romania between April and October 2025. Demographic characteristics, cardiovascular risk factors, reperfusion timelines, and in-hospital outcomes were analyzed.
Results
Mean total ischemic time was 421 min, driven predominantly by prolonged pain-to-call (229 min) and first medical contact (FMC)-to-door (102 min) intervals. In-hospital door-to-balloon times were largely compliant with European Society of Cardiology recommendations. In-hospital mortality was 8.94%.
Conclusions
STEMI care in Romania is characterized by significant pre-hospital delays despite efficient in-hospital workflows. Targeted public education, optimization of emergency medical service pathways, and broader implementation of pharmaco-invasive strategies may substantially reduce ischemic time and improve outcomes.
© 2026 Silviu I. Dumitrescu, Bucur Bara, Alexandru Marinescu, Francesco Perone, Alice Munteanu, published by Asociatia Transilvana de Terapie Transvasculara si Transplant KARDIOMED
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.