Effect of improved door-to-balloon time on clinical outcomes in patients with ST segment elevation myocardial infarction

Lee, Wei‐Chieh; Fang, Hsiu‐Yu; Chen, Huang‐Chung; Hsueh, Shu-Kai; Chen, Chien-Jen; Yang, Cheng‐Hsu; Yip, Hon‐Kan; Hang, Chi‐Ling; Wu, Chiung‐Jen; Fang, Chih-Yuan

doi:10.1016/j.ijcard.2017.02.156

Cited by 12 publications

(16 citation statements)

References 18 publications

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“…Cardiac death: any death related to myocardial infarction, cardiac arrhythmia, and heart failure [26]…”

Section: Methodsmentioning

confidence: 99%

“…Although previous studies indicated no relationship between door-to-balloon time and 1-year MACEs [21,26], there is a controversial relationship between symptom-to-balloon time and in-hospital and 1-year MACEs in the literature. Despite the strong relationship between symptom-to-balloon time and 1-year MACEs, no relationship was found between symptom-to-balloon time and in-hospital MACEs [29,30].…”

Section: Introductionmentioning

confidence: 98%

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Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study

Nozari¹,

Geraiely²,

Alipasandi³

et al. 2019

JMIR Res Protoc

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BackgroundPatients with ST-segment elevation myocardial infarction (STEMI) experience major adverse cardiac events (MACEs) following primary percutaneous coronary intervention (PCI). Although the relationship between time to treatment (eg, door-to-balloon time, symptom onset-to-balloon time, and symptom onset-to-door time) and 1-month all-cause mortality was assessed previously, its relationship with in-hospital MACEs and the effect of some clinical characteristics on this relationship were not considered. Furthermore, previous studies that were conducted in developed countries with a different quality of care cannot be applied in Iran, as Iran is a developing country and the studies were not performed according to the 24/7 primary PCI service registry.ObjectiveThe objective of this study protocol is to determine the relationship between time to treatment and in-hospital MACEs.MethodsThis cross-sectional study will take place at the Tehran Heart Center (THC), which is affiliated with Tehran University of Medical Sciences (TUMS) in Tehran, Iran. Data related to patients with STEMI, who underwent primary PCI between March 2015 and March 2019, that have been prospectively recorded in the THC’s 24/7 primary PCI service registry will be analyzed. The study outcome is the occurrence of in-hospital MACEs. Data analysis will be conducted using SPSS for Windows, version 16.0 (SPSS Inc). We will perform chi-square tests, independent-samples t tests, or the Mann-Whitney U test, as well as univariate and multivariate binary logistic regression with a significance level of less than .05 and 95% CI for odds ratios.ResultsFrom March 2015 to September 2017, 1586 patients were included in the THC service registry, consecutively. We will conduct a retrospective analysis of this registry on patient entries between March 2015 and March 2019 and data will be analyzed and published by the end of 2019.ConclusionsTo our knowledge, this is the first observational study based on the 24/7 primary PCI service registry in Iran. The findings of this study may reveal current problems regarding time to treatment in STEMI management in the THC. Results from this study may help determine appropriate preventive strategies that need to be applied in order to reduce time-to-treatment delays and improve patients’ outcomes following primary PCI in the setting of STEMI at the THC and similar clinical centers.International Registered Report Identifier (IRRID)DERR1-10.2196/13161

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“…Cardiac death: any death related to myocardial infarction, cardiac arrhythmia, and heart failure [26]…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study

Nozari¹,

Geraiely²,

Alipasandi³

et al. 2019

JMIR Res Protoc

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“…Our previous study, which investigated the determinants of short and long DTBTs, also showed that the rate of in-hospital mortality in STEMI patients with a short DTBT was lower than that in those with a long DTBT ( 6 ). On the other hand, there are few studies about the association between the DTBT and mid-term or long-term clinical outcomes ( 7 , 8 ). The purpose of this study was to investigate the association between the DTBT and mid-term all-cause death in patients with STEMI.…”

Section: Introductionmentioning

confidence: 99%

Association between the Door-to-balloon Time and Mid-term Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

et al. 2020

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Objective In primary percutaneous coronary intervention (PCI), the door-to-balloon time (DTBT) is known to be associated with in-hospital death in patients with ST-segment elevation myocardial infarction (STEMI). However, little is known regarding the association between the DTBT and the mid-term clinical outcomes in patients with STEMI. The purpose of this study was to investigate the association between the DTBT and mid-term all-cause death. Methods The study population included 309 STEMI patients, who were divided into the short DTBT (DTBT<60 minutes, n=103), intermediate DTBT (DTBT 60-120 minutes, n=174) and long DTBT (DTBT >120 minutes, n=32) groups. The median follow-up period was 287 days (interquartile range: 182-624 days). Results The incidence of all-cause death in the long DTBT group was significantly higher in comparison to the other groups (p<0.001). In the multivariate Cox regression analysis, although a short DTBT [vs. intermediate DTBT: hazard ratio (HR) 1.00, 95% confidence interval (CI) 0.39-2.55, p=0.99] was not associated with all-cause death, a long DTBT (vs. intermediate DTBT: HR 2.80, 95% CI 1.26-6.17, p=0.011) was significantly associated with all-cause death, after controlling for confounding factors such as Killip class 4, an impaired renal function, and the number of diseased vessels. Conclusion The DTBT was significantly associated with the incidence of mid-term all-cause death. Our results support the strong adherence to the DTBT in patients with STEMI.

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“…22,23 Hasil ini tidak berbeda dari penelitian Lee, dkk. 24 yang memperlihatkan berkurangnya kejadian infark berulang dan tindakan PCI ulang, namun hal tersebut berkaitan dengan penggunaan stent generasi terbaru dan terapi medikamentosa.…”

Section: Diskusiunclassified

Pengaruh Penerapan Program “CODE STEMI” terhadap Door to Balloon Time dan Major Adverse Cardiac Events Pasien ST Elevation Myocardial Infarction

Funay¹,

Wijaya²,

Ginanjar³

et al. 2021

JPDI

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Effect of improved door-to-balloon time on clinical outcomes in patients with ST segment elevation myocardial infarction

Cited by 12 publications

References 18 publications

Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study

Time to Treatment and In-Hospital Major Adverse Cardiac Events Among Patients With ST-Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention (PCI) According to the 24/7 Primary PCI Service Registry in Iran: Protocol for a Cross-Sectional Study

Association between the Door-to-balloon Time and Mid-term Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

Pengaruh Penerapan Program “CODE STEMI” terhadap Door to Balloon Time dan Major Adverse Cardiac Events Pasien ST Elevation Myocardial Infarction

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