Abstract
Introduction: Timely reperfusion (preferably via percutaneous coronary
intervention (PCI)) following myocardial infarction improves mortality. Emergency
medical services play a pivotal role in recognising and transporting patients with
ST-elevation myocardial infarction directly to a PCI facility to avoid delays to
reperfusion. Access to PCI is, in-part, dependant on the geographic distribution of
patients around PCI facilities. The aim of this study was to determine the
proportion of South Africans living within 60 and 120 minutes to a PCI facility.
Methods: PCI facility and population data were subjected to proximity analysis to
determine the average drive times from municipal ward centroids to PCI facilities
for each province in South Africa. Thereafter, the population of each ward living
within 60 and 120 minutes of a PCI facility was extrapolated.
Results: Approximately, 53.8% and 71.53% of the South African population lives
within 60 and 120 minutes of a PCI facility. The median (IQR, range) drive times
and distances to a PCI facility are 100 minutes (120.4 min, 0.7 min – 751.8 min)
across 123.6km (157.6km, 0.3km – 940.8km)..
Conclusion: Based on the proximity of South Africans to PCI facilities, it seems
possible that most patients could receive timely PCI within 120 minutes of first
medical contact. However, this may be unlikely for some due to a lack of medical
insurance, under-developed referral networks or other system delays. Coronary...