DOOR-TO-BALLOON TIME AND CARDIOVASCULAR OUTCOMES IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION TREATED WITH PRIMARY PERCUTANEOUS INTERVENTION

Abstract

Background  Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI) within 12 hours of symptom onset, provided it can be performed expeditiously (i.e., 120 min from STEMI diagnosis) by an experienced team. A professional team includes not only interventional cardiologists but also skilled support staff. Lower mortality rates among patients undergoing primary PCI are observed in centres with a high volume of PCI procedures. In addition, door-to-balloon time became an indicator of the quality of care in STEMI patients treated with primary PCI. Objectives  To evaluate the impact of door-to-balloon time delay on cardiovascular outcomes in patients with STEMI.  Methods Prospective cohort study of door-to-balloon time (DTB) delay and adverse cardiovascular outcomes in patients with STEMI treated with primary PCI. Results About 65% (n=131) of patients were free from adverse outcomes with a Mean door-to-balloon time of 92 minutes vs adverse effects (left ventricular dysfunction or angina) happened in 26% (n=52) with a mean door-to-balloon time of 168 minutes and death in 8% (n=16) with a mean time of 114 minutes (P=0.001). Similar results were found with symptom onset-to-balloon time, no adverse outcomes with a mean symptom onset-to-balloon time of 11.98 hours compared to 22 hours with adverse effects and deaths;( p=0.004.) Conclusion Any delay in door-to-balloon time or symptom onset-to-balloon time in patients with ST-elevation myocardial infarction is associated with higher morbidity and mortality rate.