engleski

Is it door-to-balloon time really important?

Authors evaluate the importance of door-to- balloon time, and symptom onset-to-balloon time (total ischemic time) for prognosis of patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). 1190 acute STEMI patients treated with primary PCI in eight centers across Croatia (Croatian Primary PCI Network) were prospectively investigated. 677 non-transferred and 513 transferred patients were divided according to door-to-balloon time in three subgroups (<90, 90-180, and >180 minutes) and according to symptom onset-to- balloon time in three subgroups (<180, 180-360, and >360 minutes). Among door-to-balloon subgroups none of results differences (for postprocedural TIMI flow, in- hospital mortality, and major adverse cardiovascular events (mortality, pectoral angina, restenosis, reinfarction, coronary artery by-pass graft and cerebrovascular accident rate) in six- month follow-up) was statistically significant. Between onset-to-balloon time subgroups a statistically significant difference on multivariate level was the highest in-hospital mortality in the subgroup of patients with longest onset-to-balloon time (4.5 vs.2.6 vs. 5.7%, p=0.04). According to these results, authors concluded that door-to-balloon time has no impact on early and six-month prognosis of acute STEMI patients. Symptom onset-to-balloon time is more accurate for this purpose.

primary PCI ; door-to-balloon time ; network

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