Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention
Background Current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommend a door-to-balloon time (DBT) of ≤ 90 min for patients undergoing primary percutaneous coronary intervention (PCI). We aimed to investigate the possible impact of further reduction in DBT i...
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| Veröffentlicht in: | Clinical research in cardiology 2019-09, Vol.108 (9), p.1053-1058 |
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| creator | Zahler, David Lee-Rozenfeld, Keren Ravid, Dor Rozenbaum, Zach Banai, Shmuel Keren, Gad Shacham, Yacov |
| description | Background
Current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommend a door-to-balloon time (DBT) of ≤ 90 min for patients undergoing primary percutaneous coronary intervention (PCI). We aimed to investigate the possible impact of further reduction in DBT intervals beyond the 90 min cutoff on short and long-term outcomes among STEMI patients undergoing primary PCI.
Methods
We retrospectively studied 889 STEMI patients (median age 61 years, 83% men) who underwent successful primary PCI and had a DBT of ≤ 90 min. Patients were stratified according to DBT into 2 groups: < 60 min and 60–90 min. Patients records were assessed for the occurrence of in-hospital complications, 30-day and 1-year mortality.
Results
Patients having DBT |
| doi_str_mv | 10.1007/s00392-019-01438-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2183639806</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2182951456</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-22485c8c494c841551fbef6f4c3f7be975d9840c41e3033f83b988de9dce05273</originalsourceid><addsrcrecordid>eNp9kcFuFiEUhYmxsbX6Ai4MiZtuRmGAGViaRqtJExNb14RhLn-mYWAEpk3fxYeV6dSauHBBIPd-59xLDkJvKHlPCek_ZEKYahtCVT2cyaZ7hk6o7GhDOtU-f3pLfoxe5nxDiKCE8RfomJG-l10nT9Cv7-BNmWLA0WEf7yBN4YDHGFNTYjMY72PtlWkGbMKI55iK8VO5x1PAV9c4w2GGUDB4uN1t5vtoTRon4yviTLIP1aU2K5fxGkZIh7gNWSDZtZgAcc3YxhSDSZtvgXRb2Sp7hY6c8RleP96n6MfnT9fnX5rLbxdfzz9eNpb1ojRty6Ww0nLFreRUCOoGcJ3jlrl-ANWLUUlOLKfACGNOskFJOYIaLRDR9uwUne2-S4o_V8hFz1O24P2-nG6pZB1TknQVffcPehPXFOp2G9UqQbnYqHanbIo5J3B6SdNcv6cp0Vt2es9O1-z0Q3Z6E719tF6HGcYnyZ-wKsB2IC9bSpD-zv6P7W8OdKhq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2182951456</pqid></control><display><type>article</type><title>Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Zahler, David ; Lee-Rozenfeld, Keren ; Ravid, Dor ; Rozenbaum, Zach ; Banai, Shmuel ; Keren, Gad ; Shacham, Yacov</creator><creatorcontrib>Zahler, David ; Lee-Rozenfeld, Keren ; Ravid, Dor ; Rozenbaum, Zach ; Banai, Shmuel ; Keren, Gad ; Shacham, Yacov</creatorcontrib><description>Background
Current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommend a door-to-balloon time (DBT) of ≤ 90 min for patients undergoing primary percutaneous coronary intervention (PCI). We aimed to investigate the possible impact of further reduction in DBT intervals beyond the 90 min cutoff on short and long-term outcomes among STEMI patients undergoing primary PCI.
Methods
We retrospectively studied 889 STEMI patients (median age 61 years, 83% men) who underwent successful primary PCI and had a DBT of ≤ 90 min. Patients were stratified according to DBT into 2 groups: < 60 min and 60–90 min. Patients records were assessed for the occurrence of in-hospital complications, 30-day and 1-year mortality.
Results
Patients having DBT < 60 min (
n
= 608, 68%) were more likely to present earlier, in daytime and weekdays, and had better post-procedural left ventricular ejection fraction and lower 30-day mortality (3% vs. 6%,
p
= 0.03). Mortality over 1-year was significantly lower among patients having DBT < 60 compared to DBT of 60–90 min (4.6% vs. 9.6%,
p
= 0.004). In a binary logistic regression model DBT < 60 min was associated with 51% risk reduction for 1-year mortality (OR 0.49, 95% CI 0.25–0.93,
p
= 0.03).
Conclusions
Among STEMI patients undergoing primary PCI within 90 min of admission DBT < 60 min was independently associated with better 1-year mortality.</description><identifier>ISSN: 1861-0684</identifier><identifier>EISSN: 1861-0692</identifier><identifier>DOI: 10.1007/s00392-019-01438-6</identifier><identifier>PMID: 30778668</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Angioplasty ; Angioplasty, Balloon, Coronary - methods ; Cardiology ; Complications ; Electrocardiography ; Female ; Heart ; Heart attacks ; Humans ; Intervention ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Myocardial infarction ; Original Paper ; Patients ; Percutaneous Coronary Intervention - methods ; Reduction ; Regression models ; Retrospective Studies ; Risk management ; ST Elevation Myocardial Infarction - mortality ; ST Elevation Myocardial Infarction - therapy ; Time Factors ; Time-to-Treatment ; Treatment Outcome ; Ventricle</subject><ispartof>Clinical research in cardiology, 2019-09, Vol.108 (9), p.1053-1058</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Clinical Research in Cardiology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-22485c8c494c841551fbef6f4c3f7be975d9840c41e3033f83b988de9dce05273</citedby><cites>FETCH-LOGICAL-c375t-22485c8c494c841551fbef6f4c3f7be975d9840c41e3033f83b988de9dce05273</cites><orcidid>0000-0002-6887-3348</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00392-019-01438-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00392-019-01438-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30778668$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zahler, David</creatorcontrib><creatorcontrib>Lee-Rozenfeld, Keren</creatorcontrib><creatorcontrib>Ravid, Dor</creatorcontrib><creatorcontrib>Rozenbaum, Zach</creatorcontrib><creatorcontrib>Banai, Shmuel</creatorcontrib><creatorcontrib>Keren, Gad</creatorcontrib><creatorcontrib>Shacham, Yacov</creatorcontrib><title>Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention</title><title>Clinical research in cardiology</title><addtitle>Clin Res Cardiol</addtitle><addtitle>Clin Res Cardiol</addtitle><description>Background
Current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommend a door-to-balloon time (DBT) of ≤ 90 min for patients undergoing primary percutaneous coronary intervention (PCI). We aimed to investigate the possible impact of further reduction in DBT intervals beyond the 90 min cutoff on short and long-term outcomes among STEMI patients undergoing primary PCI.
Methods
We retrospectively studied 889 STEMI patients (median age 61 years, 83% men) who underwent successful primary PCI and had a DBT of ≤ 90 min. Patients were stratified according to DBT into 2 groups: < 60 min and 60–90 min. Patients records were assessed for the occurrence of in-hospital complications, 30-day and 1-year mortality.
Results
Patients having DBT < 60 min (
n
= 608, 68%) were more likely to present earlier, in daytime and weekdays, and had better post-procedural left ventricular ejection fraction and lower 30-day mortality (3% vs. 6%,
p
= 0.03). Mortality over 1-year was significantly lower among patients having DBT < 60 compared to DBT of 60–90 min (4.6% vs. 9.6%,
p
= 0.004). In a binary logistic regression model DBT < 60 min was associated with 51% risk reduction for 1-year mortality (OR 0.49, 95% CI 0.25–0.93,
p
= 0.03).
Conclusions
Among STEMI patients undergoing primary PCI within 90 min of admission DBT < 60 min was independently associated with better 1-year mortality.</description><subject>Adult</subject><subject>Aged</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Cardiology</subject><subject>Complications</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Intervention</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Reduction</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Risk management</subject><subject>ST Elevation Myocardial Infarction - mortality</subject><subject>ST Elevation Myocardial Infarction - therapy</subject><subject>Time Factors</subject><subject>Time-to-Treatment</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><issn>1861-0684</issn><issn>1861-0692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kcFuFiEUhYmxsbX6Ai4MiZtuRmGAGViaRqtJExNb14RhLn-mYWAEpk3fxYeV6dSauHBBIPd-59xLDkJvKHlPCek_ZEKYahtCVT2cyaZ7hk6o7GhDOtU-f3pLfoxe5nxDiKCE8RfomJG-l10nT9Cv7-BNmWLA0WEf7yBN4YDHGFNTYjMY72PtlWkGbMKI55iK8VO5x1PAV9c4w2GGUDB4uN1t5vtoTRon4yviTLIP1aU2K5fxGkZIh7gNWSDZtZgAcc3YxhSDSZtvgXRb2Sp7hY6c8RleP96n6MfnT9fnX5rLbxdfzz9eNpb1ojRty6Ww0nLFreRUCOoGcJ3jlrl-ANWLUUlOLKfACGNOskFJOYIaLRDR9uwUne2-S4o_V8hFz1O24P2-nG6pZB1TknQVffcPehPXFOp2G9UqQbnYqHanbIo5J3B6SdNcv6cp0Vt2es9O1-z0Q3Z6E719tF6HGcYnyZ-wKsB2IC9bSpD-zv6P7W8OdKhq</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Zahler, David</creator><creator>Lee-Rozenfeld, Keren</creator><creator>Ravid, Dor</creator><creator>Rozenbaum, Zach</creator><creator>Banai, Shmuel</creator><creator>Keren, Gad</creator><creator>Shacham, Yacov</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6887-3348</orcidid></search><sort><creationdate>20190901</creationdate><title>Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention</title><author>Zahler, David ; Lee-Rozenfeld, Keren ; Ravid, Dor ; Rozenbaum, Zach ; Banai, Shmuel ; Keren, Gad ; Shacham, Yacov</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-22485c8c494c841551fbef6f4c3f7be975d9840c41e3033f83b988de9dce05273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Cardiology</topic><topic>Complications</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Intervention</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention - methods</topic><topic>Reduction</topic><topic>Regression models</topic><topic>Retrospective Studies</topic><topic>Risk management</topic><topic>ST Elevation Myocardial Infarction - mortality</topic><topic>ST Elevation Myocardial Infarction - therapy</topic><topic>Time Factors</topic><topic>Time-to-Treatment</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zahler, David</creatorcontrib><creatorcontrib>Lee-Rozenfeld, Keren</creatorcontrib><creatorcontrib>Ravid, Dor</creatorcontrib><creatorcontrib>Rozenbaum, Zach</creatorcontrib><creatorcontrib>Banai, Shmuel</creatorcontrib><creatorcontrib>Keren, Gad</creatorcontrib><creatorcontrib>Shacham, Yacov</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical research in cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zahler, David</au><au>Lee-Rozenfeld, Keren</au><au>Ravid, Dor</au><au>Rozenbaum, Zach</au><au>Banai, Shmuel</au><au>Keren, Gad</au><au>Shacham, Yacov</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention</atitle><jtitle>Clinical research in cardiology</jtitle><stitle>Clin Res Cardiol</stitle><addtitle>Clin Res Cardiol</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>108</volume><issue>9</issue><spage>1053</spage><epage>1058</epage><pages>1053-1058</pages><issn>1861-0684</issn><eissn>1861-0692</eissn><abstract>Background
Current guidelines for the treatment of ST-segment elevation myocardial infarction (STEMI) recommend a door-to-balloon time (DBT) of ≤ 90 min for patients undergoing primary percutaneous coronary intervention (PCI). We aimed to investigate the possible impact of further reduction in DBT intervals beyond the 90 min cutoff on short and long-term outcomes among STEMI patients undergoing primary PCI.
Methods
We retrospectively studied 889 STEMI patients (median age 61 years, 83% men) who underwent successful primary PCI and had a DBT of ≤ 90 min. Patients were stratified according to DBT into 2 groups: < 60 min and 60–90 min. Patients records were assessed for the occurrence of in-hospital complications, 30-day and 1-year mortality.
Results
Patients having DBT < 60 min (
n
= 608, 68%) were more likely to present earlier, in daytime and weekdays, and had better post-procedural left ventricular ejection fraction and lower 30-day mortality (3% vs. 6%,
p
= 0.03). Mortality over 1-year was significantly lower among patients having DBT < 60 compared to DBT of 60–90 min (4.6% vs. 9.6%,
p
= 0.004). In a binary logistic regression model DBT < 60 min was associated with 51% risk reduction for 1-year mortality (OR 0.49, 95% CI 0.25–0.93,
p
= 0.03).
Conclusions
Among STEMI patients undergoing primary PCI within 90 min of admission DBT < 60 min was independently associated with better 1-year mortality.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30778668</pmid><doi>10.1007/s00392-019-01438-6</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-6887-3348</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1861-0684 |
| ispartof | Clinical research in cardiology, 2019-09, Vol.108 (9), p.1053-1058 |
| issn | 1861-0684 1861-0692 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2183639806 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Angioplasty Angioplasty, Balloon, Coronary - methods Cardiology Complications Electrocardiography Female Heart Heart attacks Humans Intervention Male Medicine Medicine & Public Health Middle Aged Mortality Myocardial infarction Original Paper Patients Percutaneous Coronary Intervention - methods Reduction Regression models Retrospective Studies Risk management ST Elevation Myocardial Infarction - mortality ST Elevation Myocardial Infarction - therapy Time Factors Time-to-Treatment Treatment Outcome Ventricle |
| title | Relation of lowering door-to-balloon time and mortality in ST segment elevation myocardial infarction patients undergoing percutaneous coronary intervention |
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