Early reperfusion is the cornerstone to therapy in patients admitted with ST- elevation myocardial infarction (STEMI).

Several performance metrics such as first medical contact to device (FMC-to- device) time, door to balloon (D2B)

time, and onset to balloon (OTB) time have been utilized , all with the initiative to minimize total ischemic time.

The pre-hospital course of a a patient with STEMI is crucial in minimizing total ischemic time. Patients with STEMI

arriving to the hospital by Emergency medical services (EMS) have been shown to have shorter D2B times [6] and

lower mortality rates when compared to patients presenting without EMS transportation. Furthermore, pre-

hospital electrocardiography ( ECG) and STEMI notification results in smaller infarct size [8], improved reperfusion

times, and less STEMI complications. However, emergency medical services (EMS) continue to be underutilized

in patients presenting with STEMI worldwide.

In Lebanon, data and registries on use of EMS in patients with acute coronary syndromes (ACS) are lacking. No

studies have addressed the effect of EMS use on the outcome of patients with ACS arriving to the hospital. Thus, our

study aims to determine the prevalence of Emergency medical service (EMS) utilization among patients presenting

with ST- segment elevation myocardial infarction (STEMI) to the Emergency Department (ED) atin the American

University of Beirut Medical Center (AUBMC) in Lebanon and to compare the clinical outcome of STEMI patients

arriving to our ED by EMS or versus by personal transportation.

Patients presenting to AUBMC ED with STEMI diagnosis 

Chart review conducted to determine STEMI patients following STEMI diagnosis criteria