The Influence of Presentation Timing and Door to Balloon Timing on the Clinical Outcomes in Primary Percutaneous Coronary Intervention

Abstract

For best clinical results, ST-segment elevation myocardial infarction (STEMI) must be treated quickly. This prospective observational study, conducted at Peshawar institute of cardiology (PIC), Pakistan, from November 23, 2022, to August 16, 2023, examines the connection between clinical outcomes in 120 primary Percutaneous Coronary Intervention (PCI) cases, presentation timing (the period of time from symptom onset to hospital arrival), and Door-to-Balloon (D2B) time. Objective: to pave the road for more efficient, patient-centered care by fostering a more thorough awareness of the complexities involved in the management of acute STEMI. Methods: Demographic data, presentation timing, D2B times, and clinical outcomes were collected. Correlation analysis and regression modeling were employed to investigate the impact of presentation timing on D2B time and clinical outcomes. Sub-group analyses were conducted based on age and gender. Results: The relevance of an early presentation was highlighted by the study's substantial negative association between presentation timing and D2B time (r = -0.62, p 0.001). Smaller myocardial infarct sizes and a decreased frequency of major adverse cardiac events (MACE) were seen in patients with D2B times under 90 minutes. Age and gender differences were seen in this connection, according to subgroup analysis. Conclusion: Timely patient presentation is crucial in achieving shorter D2B times, leading to improved clinical outcomes in primary PCI for STEMI. These findings underscore the need for public awareness campaigns and streamlined hospital protocols to optimize STEMI management.