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Door-to-balloon time and mortality among patients undergoing primary PCI

Original Research | By Menees DS, Peterson ED, Wang Y et al.

BACKGROUND - Current guidelines for the treatment of ST-segment elevation myocardial infarction recommend a door-to-balloon time of 90 minutes or less for patients undergoing primary percutaneous coronary intervention (PCI). Door-to-balloon time has become a performance measure and is the focus of regional and national quality-improvement initiatives. However, it is not known whether national improvements in door-to-...

Off-hour presentation and outcomes in patients with acute myocardial infarction: systematic review and meta-analysis

Review Article | By Sorita A, Ahmed A, Starr SR et al.

OBJECTIVE - To assess the association between off-hour (weekends and nights) presentation, door to balloon times, and mortality in patients with acute myocardial infarction. DATA SOURCES - Medline in-process and other non-indexed citations, Medline, Embase, Cochrane Database of Systematic Reviews, and Scopus through April 2013. STUDY SELECTION - Any st...

Frequency of nonsystem delays in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention and implications for door-to-balloon time reporting (from the American Heart Association Mission: Lifeline program)

Original Research | By Cotoni DA1, Roe MT, Kontos MC et al.

The percentage of patients with primary percutaneous coronary intervention (PCI) with door-to-balloon (D2B) times ≤90 minutes is used as a hospital performance measure for public reporting. Patients can be excluded from reporting for nonsystem-related delays. How exclusions impact D2B time reporting at the hospital level is unknown. The percentage of patients having nonsystem delays for primary PCI at the hospital level was calculated usi...

Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study

Original Research | By Nallamothu BK, Normand SL, Wang Y et al.

BACKGROUND - Recent reductions in average door-to-balloon (D2B) times have not been associated with decreases in mortality at the population level. We investigated this seemingly paradoxical finding by assessing components of this association at the individual and population levels simultaneously. We postulated that the changing population of patients undergoing primary percutaneous coronary intervention (pPCI) contributed to se...

Location of the culprit coronary lesion and its association with delay in door-to-balloon time (from a multicenter registry of primary percutaneous coronary intervention)

Original Research | By Kuno T, Kohsaka S, Numasawa Y et al.

Current guidelines recommend shorter door-to-balloon times (DBTs) (<90 minutes) for patients with ST-elevation myocardial infarction (STEMI). Clinical factors, including patient or hospital characteristics, associated with prolonged DBT have been identified, but angiographic variables such as culprit lesion location have not been thoroughly investigated. We aimed to evaluate the effect of culprit artery location on DBT of patients with...

Balloon-to-door time: emerging evidence for shortening hospital stay after primary PCI for STEMI

Editorial | By Resnic FS, Shah SP

Nearly 250,000 patients have an ST-segment elevation myocardial infarction (STEMI) each year in the United States, and this condition results in an estimated 1 million hospital days and more than $6 billion in hospital-related costs (1,2). Reducing length of hospital stay (LOS) in this population, while maintaining quality and outcomes, would likely result in dramatic cost savings for the U.S. health care system. Success in the management of S...

Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries

Original Research | By Chung SC, Sundström J, Gale CP et al.

OBJECTIVE - To assess the between hospital variation in use of guideline recommended treatments and clinical outcomes for acute myocardial infarction in Sweden and the United Kingdom. DESIGN - Population based longitudinal cohort study using nationwide clinical registries. SETTING AND PARTICIPANTS - Nationwide registry data comprising all hospitals provid...

Door to Balloon Time: Is There a Point That Is Too Short?

Review Article | By Sutton NR, Gurm HS et al.

The duration of ischemic time is directly related to permanent myocardial damage and mortality in the setting of ST-elevation myocardial infarction (STEMI). Rapidly restoring myocardial blood flow to limit the total ischemic time is a priority. The time duration between a patient entering the medical system and being treated with percutaneous coronary intervention to open the occluded culprit vessel is termed door-to-balloon (DTB) time, whic...

Aggressive Measures to Decrease

Original Research | By Fanari Z, Abraham N, Kolm P et al.

OBJECTIVE - To assess the impact of an aggressive protocol to decrease the time from hospital arrival to onset of reperfusion therapy ("door to balloon [DTB] time") on the incidence of false-positive (FP) diagnosis of ST-segment elevation myocardial infarction (STEMI) and in-hospital mortality. PATIENTS AND METHODS - The study population included 1031 consecutive patients with presumed STEMI and con...

6- Versus 24-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents in Patients Nonresistant to Aspirin Final Results of the ITALIC Trial (Is There a Life for DES After Discontinuation of Clopidogrel)

Clinical Trial | By Didier R, Morice MC, Gilard M et al.

OBJECTIVES - The aim of this study was to test the hypothesis that 6-month dual antiplatelet therapy (DAPT) is noninferior to 24-month DAPT in aspirin-sensitive patients. BACKGROUND - The ITALIC (Is There a Life for DES After Discontinuation of Clopidogrel) trial showed that rates of bleeding and thrombotic ev...

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左主干暨冠状动脉分叉病变峰会

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