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May 19, 2009BMJOpen Access

Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study

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Why the study?

Does shorter door-to-balloon time reduce in-hospital mortality in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention?

Population

43,801 patients with ST elevation myocardial infarction undergoing primary percutaneous coronary…

Comparison

Shorter door-to-balloon time vs Longer door-to-balloon times

Design

Cohort

Follow-up

In-hospital

Authors

SRS.S. RathoreJCJeptha P. CurtisJCJuliana Chen

Discussion

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Overview

Supports minimizing door-to-balloon time in STEMI; extends observational data but leaves causal benefit of sub-90-minute targets open.

Structured PICO

Does shorter door-to-balloon time reduce in-hospital mortality in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention?

P
Population
43,801 patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention enrolled in the American College of Cardiology National Cardiovascular Data Registry, 2005-6.
I
Intervention
Shorter door-to-balloon time (evaluating reductions to less than 90 minutes)
C
Comparator
Longer door-to-balloon times
O
Outcome
Mortality in hospitalhard clinical

Any delay in primary percutaneous coronary intervention after hospital arrival is associated with higher in-hospital mortality in STEMI patients, indicating that time to treatment should be minimized even below the standard 90-minute benchmark.

Cite This Study

Rathore et al. (2009) studied this question.

synapsesocial.com/papers/6a7d43d9b97b7d2d4f83e233https://doi.org/10.1136/bmj.b1807
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Door-to-Balloon Time With Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction Impacts Late Cardiac Mortality in High-Risk Patients and Patients Presenting Early After the Onset of Symptoms2006 · 238 citations
  2. 2Time Delay to Treatment and Mortality in Primary Angioplasty for Acute Myocardial Infarction2004 · 1,557 citations
  3. 3Time is muscle in primary PCI: the strength of the evidence grows2004 · 39 citations
  4. 4Relationship Between Delay in Performing Direct Coronary Angioplasty and Early Clinical Outcome in Patients With Acute Myocardial Infarction1999 · 578 citations
  5. 5Relationship of treatment delays and mortality in patients undergoing fibrinolysis and primary percutaneous coronary intervention. The Global Registry of Acute Coronary Events2007 · 182 citations