BACKGROUND: Reperfusion therapy improves both mortality and morbidity in patients with ST-elevation myocardial infarction (STEMI). Timeliness of such reperfusion is an important factor in improving patient survival. For percutaneous coronary intervention (PCI), the American College of Cardiology has recommended a goal of <90 minutes from initial hospital contact to first balloon inflation. METHODS: The authors retrospectively reviewed 131 patients with a diagnosis of STEMI seen at a PCI capable hospital between January, 2006 and September, 2008, a period of time before and after implementation of a protocol aimed at reducing door-to-balloon time. Sixty-one percent of study population was Asian or Pacific Islander. This protocol was largely based on the identification by Bradley et al. of factors whose modification could shorten this time interval. RESULTS: Time to reperfusion was compared between groups before (n=57), and after (n=58) protocol implementation. Median door-to-balloon time for the former group was 133 minutes, interquartile range (IQRs), (25th, 75th percentile; 104.5, 147), and for the latter group 67 minutes, IQRs (56, 80) respectively (p<0.001). Prior to implementation of the protocol, a door-to-balloon time of <90 minutes was achieved in 17% of cases. By the third quarter of 2008, this goal was being met in 100%. CONCLUSION: This observational study provides support for the use of the strategies described as a key for reduction in door-to-balloon time. Hawaii Medical Journal Copyright 2010.
BACKGROUND: Reperfusion therapy improves both mortality and morbidity in patients with ST-elevation myocardial infarction (STEMI). Timeliness of such reperfusion is an important factor in improving patient survival. For percutaneous coronary intervention (PCI), the American College of Cardiology has recommended a goal of <90 minutes from initial hospital contact to first balloon inflation. METHODS: The authors retrospectively reviewed 131 patients with a diagnosis of STEMI seen at a PCI capable hospital between January, 2006 and September, 2008, a period of time before and after implementation of a protocol aimed at reducing door-to-balloon time. Sixty-one percent of study population was Asian or Pacific Islander. This protocol was largely based on the identification by Bradley et al. of factors whose modification could shorten this time interval. RESULTS: Time to reperfusion was compared between groups before (n=57), and after (n=58) protocol implementation. Median door-to-balloon time for the former group was 133 minutes, interquartile range (IQRs), (25th, 75th percentile; 104.5, 147), and for the latter group 67 minutes, IQRs (56, 80) respectively (p<0.001). Prior to implementation of the protocol, a door-to-balloon time of <90 minutes was achieved in 17% of cases. By the third quarter of 2008, this goal was being met in 100%. CONCLUSION: This observational study provides support for the use of the strategies described as a key for reduction in door-to-balloon time. Hawaii Medical Journal Copyright 2010.
Authors: Michel R Le May; Derek Y So; Richard Dionne; Chris A Glover; Michael P V Froeschl; George A Wells; Richard F Davies; Heather L Sherrard; Justin Maloney; Jean-François Marquis; Edward R O'Brien; John Trickett; Pierre Poirier; Sheila C Ryan; Andrew Ha; Phil G Joseph; Marino Labinaz Journal: N Engl J Med Date: 2008-01-17 Impact factor: 91.245
Authors: P B Berger; S G Ellis; D R Holmes; C B Granger; D A Criger; A Betriu; E J Topol; R M Califf Journal: Circulation Date: 1999-07-06 Impact factor: 29.690
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Authors: C P Cannon; C M Gibson; C T Lambrew; D A Shoultz; D Levy; W J French; J M Gore; W D Weaver; W J Rogers; A J Tiefenbrunn Journal: JAMA Date: 2000-06-14 Impact factor: 56.272
Authors: Elliott M Antman; Daniel T Anbe; Paul Wayne Armstrong; Eric R Bates; Lee A Green; Mary Hand; Judith S Hochman; Harlan M Krumholz; Frederick G Kushner; Gervasio A Lamas; Charles J Mullany; Joseph P Ornato; David L Pearle; Michael A Sloan; Sidney C Smith Journal: J Am Coll Cardiol Date: 2004-08-04 Impact factor: 24.094
Authors: Richard E Waters; Kanwar P Singh; Matthew T Roe; Mat Lotfi; Michael H Sketch; Kenneth W Mahaffey; L Kristin Newby; John H Alexander; Robert A Harrington; Robert M Califf; Christopher B Granger Journal: J Am Coll Cardiol Date: 2004-06-16 Impact factor: 24.094