Original Article http://seer.ufrgs.br/hcpa ISSN 2357-9730 30 Clin Biomed Res. 2018;38(1):30-34 http://dx.doi.org/10.4322/2357-9730.75542 On- vs. Off-hOurs admissiOn Of patients with st-elevatiOn acute myOcardial infarctiOn undergOing percutaneOus cOrOnary interventiOns: data frOm a tertiary university Brazilian hOspital Guilherme Pinheiro Machado 1 , Gustavo Neves de Araujo 2 , Stéfani Mariani 1 , Elvis Cassol 1 , Felipe Homem Valle 2 , Ana Maria Krepsky 2 , Luiz Carlos Corsetti Bergoli 2 , Sandro Cadaval Gonçalves 2 , Rodrigo Wainstein 2 , Marco Wainstein 1,2 1 Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre, RS, Brasil. 2 Serviço de Cardiologia, Hospital de Clinicas de Porto Alegre. Porto Alegre, RS, Brasil. Corresponding author: Guilherme Pinheiro Machado pinmach@hotmail.com Hospital de Clínicas de Porto Alegre Rua Ramiro Barcelos, 2350. 90035-903, Porto Alegre, RS, Brasil. ABSTRACT Introduction: Early reperfusion therapy is crucial in patients with ST-elevation myocardial infarction (STEMI). Off-hours hospital presentation may increase the time from pain to coronary reperfusion, and it may be responsible for increased cardiovascular outcomes. The aim of this study was to compare the effect of different times of presentation (on- and off-hours) on early mortality and major cardiovascular outcomes in patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Methods: We have included consecutive patients with STEMI who underwent primary PCI between April 2011 and November 2016 in a tertiary university hospital in southern Brazil. Patients were divided into on- and off-hours admission. In-hospital and 30-day outcomes were evaluated. Results: A total of 301 patients (57.4%) were admitted during off-hours, and 223 (42.5%) during on-hours. Baseline characteristics were well balanced between the two groups. Median door-to-balloon time was higher in the off-hours group than in the on-hours group: 75 min (IQR 60-95) vs. 60 min (IQR 50-73.7) respectively (p < 0.001). In-hospital mortality was similar between groups (odds ratio [OR] = 0.56; 95% confdence interval [95%CI] 0.31-1.03; p = 0.06) and at 30-day follow-up (OR = 0.2; 95%CI 0.02-1.72 p = 0.14). In the matched cohort, no difference was found in the rates of in-hospital mortality (OR = 2.0; 95%CI 0.75-5.32; p = 0.16) and 30-day MACE (OR= 0.9; 95%CI 0.49-1.66; p = 0.75). Conclusions: In our center with PCI available 24/7 - without in-house staff - we did not observe any difference in patient characteristics, management, and outcomes, although a signifcant longer door-to-balloon time was found in patients treated during night shifts. Our results are consistent with those of other trials. Keywords: Myocardial infarction; percutaneous coronary intervention; system delay INTRODUCTION Early and effective reperfusion therapy is known to be the most important component of treatment for ST-elevation myocardial infarction (STEMI), being responsible for reduction in infarct size, preservation of ventricular function, and signifcant decrease of morbidity and mortality. Furthermore, the beneft of any type of treatment decreases as the time to onset of symptoms increases 1 . While fbrinolytic therapy has complete reperfusion rates of only 50-60% of patients, this number rises to 95% of cases in percutaneous coronary intervention (PCI). In addition, when analyzing short-term outcomes, it was found that patients