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Door to Balloon Time: Is There a Point That Is Too Short? Nonculprit Stenosis Evaluation Using Instantaneous Wave-Free Ratio in Patients With ST-Segment Elevation Myocardial Infarction Symptom-Onset-To-Balloon Time, ST-Segment Resolution and In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention in China: From China Acute Myocardial Infarction Registry Patterns and associations between DAPT cessation and 2-year clinical outcomes in left main/proximal LAD versus other PCI: Results from the Patterns of Non-Adherence to Dual Antiplatelet Therapy in Stented Patients (PARIS) registry Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries Comparison of Accuracy of One-Use Methods for Calculating Fractional Flow Reserve by Intravascular Optical Coherence Tomography to That Determined by the Pressure-Wire Method Targeting the Immune System in Atherosclerosis: JACC State-of-the-Art Review Screening for Atrial Fibrillation With ECG: USPSTF Recommendation 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) Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney disease

Review Article2015 Nov-Dec;58(3):230-40.

JOURNAL:Prog Cardiovasc Dis. Article Link

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

Sutton NR, Gurm HS et al. Keywords: Coronary angiography; Myocardial infarction; Outcome assessment; Percutaneous coronary intervention; Quality improvement; Reperfusion

ABSTRACT

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, which is publicly reported and used to judge hospital quality of care. While longer DTB time is associated with increased mortality in the setting of STEMI, efforts to lower DTB time have not translated into decreased mortality. Here we review the literature on DTB time, explore the factors thought to influence the interpretation of the association between DTB time and mortality, and make suggestions on goals for future efforts related to DTB time.