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 study that evaluated the association bet...
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...
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 secular trends t...
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 STE...
Balloon-to-door time: emerging evidence for shortening hospital stay after primary PCI for STEMI
Editorial | By Resnic FS, Shah SP
Nonrandomized data suggest that an early discharge strategy in low-risk patients is safe (11,12), but randomized trials investigating the safety of early discharge are small and significantly underpowered (13–15). The largest of these trials had a statistical power of <20% to detect a difference in cardiovascular events by 6 months (14). PAMI-II (Primary Angioplasty in Myocardial Infarction II) randomized 471 low-risk patients to an early discharge or...
Original Research | By Chung SC, Sundström J, Gale CP et al.
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...
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 confir...
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 events at 1 year were much the s...
Original Research | By Biswas S, Duffy SJ, Stub D et al.
Over the last decade, systems of care for ST-elevation myocardial infarction (STEMI) have evolved to try to improve outcomes and timely access to percutaneous coronary intervention (PCI). There have also been advances in PCI techniques and adjunctive pharmacotherapies. In this study, we sought to determine temporal changes in practices and clinical outcomes of PCI in patients with STEMI. We prospectively collected data on 8,412 consec...