Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention

2019 ◽  
Vol 108 (9) ◽  
pp. 1053-1058 ◽  
Author(s):  
David Zahler ◽  
Keren Lee-Rozenfeld ◽  
Dor Ravid ◽  
Zach Rozenbaum ◽  
Shmuel Banai ◽  
...  
2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Fu-Cheng Chen ◽  
Yan-Ren Lin ◽  
Chia-Te Kung ◽  
Cheng-I Cheng ◽  
Chao-Jui Li

Background. The study aimed to verify the effect of primary percutaneous coronary intervention (PPCI) with <60 min door-to-balloon time on ST segment elevation myocardial infarction (STEMI) patients’ prognoses. Methods. Outcomes of patients receiving PPCI with door-to-balloon time of <60 min were compared with those of patients receiving PPCI with door-to-balloon time 60–90 min. Result. Totally, 241 STEMI patients (191 with Killip classes I or II) and 104 (71 with Killip classes I or II) received PPCI with door-to-balloon time <60 and 60–90 min, respectively. Killip classes I and II patients with door-to-balloon time <60 min had better thrombolysis in myocardial infarction (TIMI) flow (9.2% fewer patients with TIMI flow <3, p=0.019) and 8.0% lower 30-day mortality rate (p<0.001) than those with 60–90 min. After controlling the confounding factors with logistic regression, patients with door-to-balloon time <60 min had lower incidences of TIMI flow <3 (aOR = 0.4, 95% CI = 0.20–0.76), 30-day recurrent myocardial infarction (aOR = 0.3, 95% CI = 0.10–0.91), and 30-day mortality (aOR = 0.3, 95% CI = 0.09–0.77) than those with 60–90 min. Conclusion. Door-to-balloon time <60 min is associated with better blood flow in the infarct-related artery and lower 30-day recurrent myocardial infarction and 30-day mortality rates.


Author(s):  
Filipe Merini ◽  
André Felippe ◽  
Roberto Silva ◽  
Tammuz Fattah ◽  
Daniel Moreira

Background: In ST-segment elevation myocardial infarction, the main therapy is early arterial reperfusion, performed by primary percutaneous coronary intervention. The recommended door-to-balloon time is <90 minutes. The objective of this study was to associate the door-to-balloon time and clinical factors with hospital shifts. Methods: This was a cross-sectional observational study, part of the Catarina Heart Study. We analyzed patients diagnosed with ST-segment elevation myocardial infarction in hospitals of the metropolitan area of Florianópolis, from 2016 to 2020. The qualitative variables were analyzed using the Chi-square test, and the quantitative variables were analyzed using the Student’s t test and Mann-Whitney test. Results: A total of 318 patients were analyzed, with a mean age of 58.7±11.4 years, predominantly male (71.7%) and hypertensive (53.7%). The median door-to-balloon time was significantly lower in the group seen on weekdays compared to the group seen on weekends, respectively, 71.0 (51.0-126.0) minutes and 91.0 (71.0-123.0) minutes (p=0.028). There was no difference in the door-to-balloon time in the night shift and in off-hours. Individuals undergoing primary percutaneous coronary intervention during the night shift showed a non-significant tendency for higher mortality rates from any cause (1.9%) compared to those seen during the day shift (0.0%; p=0.057). Conclusion: Patients with ST-segment elevation myocardial infarction seen on weekdays have shorter door-to-balloon time.


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