Impact of Door-to-Balloon Time on Clinical Outcomes in Patients with ST-Elevation Myocardial Infarction
- 1. Associate Professor, Department of Cardiology, KIMS, Bhubaneshwar, Odisha, India
- 2. Assistant Professor, Department of Cardiology, KIMS, Bhubaneshwar, Odisha, India
Description
Background: Studies on the connection between the Door-to-Balloon time and ST-Elevation myocardial infarction have produced inconsistent findings. Although its effectiveness may be constrained by delivery delays, prompt percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI) can considerably reduce mortality and morbidity. For patients with ST-segment elevation myocardial infarction (STEMI) receiving primary percutaneous coronary intervention, we wanted to ascertain the impact of door-to-balloon time on death (PCI). Methods: For three years, we conducted a cohort analysis of 292 STEMI patients treated with PCI within six hours of presentation at our hospital. We assessed the impact of door-to-balloon time on in-hospital mortality using hierarchical models in the full cohort as well as in other patient subgroups based on symptom onset-to-door time and baseline risk status. Results: Increased in-hospital mortality was linked to longer door-to-balloon timings (mortality rates of 3.0%, 4.2%, 5.7%, and 7.4% for door-to-balloon times of ≤ 90 min, 91 to 120 min, 121 to 150 min, and > 150 min, respectively; p-value= 0.01) Patients with a door-to-balloon time more than 120 minutes had a higher risk of dying than those with a door-to-balloon time of 90 minutes (odds ratio 1.42; 95 percent confidence interval [CI] 1.24 to 1.62). In subgroup analyses, mortality increased with longer door-to-balloon times independent of the length of time between the beginning of symptoms and the door (≤ 1 h, >1 to 2 h, >2 h), as well as the presence or absence of high-risk factors. Conclusions: Regardless of how long it takes for symptoms to manifest and regardless of the pre-existing risk of mortality, the time from primary PCI to mortality risk is crucial. All patients should be included in efforts to reduce door-to-balloon times.
Abstract (English)
Background: Studies on the connection between the Door-to-Balloon time and ST-Elevation myocardial infarction have produced inconsistent findings. Although its effectiveness may be constrained by delivery delays, prompt percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction (STEMI) can considerably reduce mortality and morbidity. For patients with ST-segment elevation myocardial infarction (STEMI) receiving primary percutaneous coronary intervention, we wanted to ascertain the impact of door-to-balloon time on death (PCI). Methods: For three years, we conducted a cohort analysis of 292 STEMI patients treated with PCI within six hours of presentation at our hospital. We assessed the impact of door-to-balloon time on in-hospital mortality using hierarchical models in the full cohort as well as in other patient subgroups based on symptom onset-to-door time and baseline risk status. Results: Increased in-hospital mortality was linked to longer door-to-balloon timings (mortality rates of 3.0%, 4.2%, 5.7%, and 7.4% for door-to-balloon times of ≤ 90 min, 91 to 120 min, 121 to 150 min, and > 150 min, respectively; p-value= 0.01) Patients with a door-to-balloon time more than 120 minutes had a higher risk of dying than those with a door-to-balloon time of 90 minutes (odds ratio 1.42; 95 percent confidence interval [CI] 1.24 to 1.62). In subgroup analyses, mortality increased with longer door-to-balloon times independent of the length of time between the beginning of symptoms and the door (≤ 1 h, >1 to 2 h, >2 h), as well as the presence or absence of high-risk factors. Conclusions: Regardless of how long it takes for symptoms to manifest and regardless of the pre-existing risk of mortality, the time from primary PCI to mortality risk is crucial. All patients should be included in efforts to reduce door-to-balloon times.
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IJPCR,Vol14,Issue7,Article8.pdf
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Additional details
Dates
- Accepted
-
2022-06-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue7,Article8.pdf
- Development Status
- Active
References
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