Prehospital 12-lead ECG and outcomes in acute coronary syndrome
Authors' conclusion
Use of PHECG by EMS for patients with ACS is associated with lower short-term mortality and higher odds of receiving reperfusion for STEMI patients. Administration of PHECG increased steadily over time, but at the end of the study, still 15% of eligible patients did not receive a PHECG.
Study context
- Population
- Patients with acute coronary syndrome (ACS) conveyed by the Emergency Medical Services (EMS) to hospital in England and Wales, 1 January 2010 to 31 December 2017eligible patients transferred by EMS, 263,420 (79.7%) had prehospital ECG (PHECG) recorded
- Participants
- 330,713 patients
- Exposure
- PHECG administration
- PHECGn = 263,420
- Outcome
- Proportion of patients where PHECG was recorded
- Follow-up
- 2010 to 2017
Methodological detailsMyocardial Ischaemia National Audit Project data
- Myocardial Ischaemia National Audit Project data
Main finding
As reported in the abstract
PHECG recorded
79.7%
2010
74.2%
2017
85.0%
Observational data: associations, not effects.
Further findings
| Outcome | PHECG | No PHECG | Adjusted OR (95% CI) | |
|---|---|---|---|---|
| All-cause mortality · 30 days | 7.1% | 10.9% | 0.77 (0.75–0.80) | |
| All-cause mortality · 1 year | 14.2% | 23.2% | 0.69 (0.68–0.71) | |
| Reperfusion in patients with STEMIWith similar adjustment | 84.5% | 54.7% | 4.37 (4.20–4.54) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Baseline characteristics
Median age PHECG 70 years · No PHECG 75 years
Female
Diabetes
Peripheral vascular disease
- All-cause mortality: Adjustment accommodated demographic characteristics, comorbidities and medical history.
Original publication
Prehospital 12-lead ECG and outcomes in acute coronary syndrome. Heart. Published 10 September 2025. doi:10.
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