This review highlights the ongoing challenge of meeting the 90-minute door-to-balloon time goal in primary PCI for STEMI and discusses strategies to minimize delays and optimize reperfusion therapy.
Early administration of reperfusion therapy improves survival among patients with ST-elevation myocardial infarction. For primary percutaneous intervention, a goal of 90 minutes or less for door-to-balloon time is incorporated into many measures of quality performance, but delay remains common, with little improvement in this measure over recent years. This review examines the strategies for reducing door-to-balloon time and for selecting the appropriate reperfusion therapy, especially when a delay is unavoidable.
Nallamothu et al. (2007) studied this question.