Wei-Chieh Lee1, Hsiu-Yu Fang1, Huang-Chung Chen1, Shu-Kai Hsueh1, Chien-Jen Chen1, Cheng-Hsu Yang1, Hon-Kan Yip1, Chi-Ling Hang1, Chiung-Jen Wu1, Chih-Yuan Fang2. 1. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China. 2. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China. Electronic address: leeweichieh@yahoo.com.tw.
Abstract
OBJECTIVE: Few studies have focused on the effects of an improved door-to-balloon time on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to explore the effect of improving door-to-balloon time on prognosis and to identify major predictors of mortality. METHODS: From January 2005 to December 2014, 1751 patients experienced STEMI and received primary percutaneous intervention in our hospital. During a 10-year period, the patients were divided into two groups according to the time period. Since mid-2009, shortening door-to-balloon time has been an important concern of health care. As a result of targeted efforts, as of January 2010, door-to-balloon time shortened significantly. In our study, a total 853 patients were in group 1 during January 2005 to December 2009, and a total 898 patients were in group 2 during January 2010 to December 2014. RESULTS: The incidence of major adverse cardiac cerebral events (26.7% vs. 23.2%; p=0.120), the incidence of cardiovascular mortality (9.3% vs. 8.8%; p=0.741), and the incidence of all-cause mortality (12.6% vs. 12.2%; p=0.798) were similar between the two groups. The incidence of target vessel revascularization significantly decreased in group 2 (17.8% vs. 12.6%; p=0.008). However, the incidence of stroke increased in group 2 (1.8% vs. 3.6%; p=0.034). CONCLUSION: Improving door-to-balloon time could not improve 1-year cardiovascular mortality whether low-risk or high-risk patients. The improvement in the door-balloon time does not improve outcomes studied, probably because it is not accompanied by a reduction in total reperfusion time, which means from onset of symptoms to reperfusion.
OBJECTIVE: Few studies have focused on the effects of an improved door-to-balloon time on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to explore the effect of improving door-to-balloon time on prognosis and to identify major predictors of mortality. METHODS: From January 2005 to December 2014, 1751 patients experienced STEMI and received primary percutaneous intervention in our hospital. During a 10-year period, the patients were divided into two groups according to the time period. Since mid-2009, shortening door-to-balloon time has been an important concern of health care. As a result of targeted efforts, as of January 2010, door-to-balloon time shortened significantly. In our study, a total 853 patients were in group 1 during January 2005 to December 2009, and a total 898 patients were in group 2 during January 2010 to December 2014. RESULTS: The incidence of major adverse cardiac cerebral events (26.7% vs. 23.2%; p=0.120), the incidence of cardiovascular mortality (9.3% vs. 8.8%; p=0.741), and the incidence of all-cause mortality (12.6% vs. 12.2%; p=0.798) were similar between the two groups. The incidence of target vessel revascularization significantly decreased in group 2 (17.8% vs. 12.6%; p=0.008). However, the incidence of stroke increased in group 2 (1.8% vs. 3.6%; p=0.034). CONCLUSION: Improving door-to-balloon time could not improve 1-year cardiovascular mortality whether low-risk or high-risk patients. The improvement in the door-balloon time does not improve outcomes studied, probably because it is not accompanied by a reduction in total reperfusion time, which means from onset of symptoms to reperfusion.
Authors: Chris F Bladin; Kathleen L Bagot; Michelle Vu; Joosup Kim; Stephen Bernard; Karen Smith; Grant Hocking; Tessa Coupland; Debra Pearce; Diane Badcock; Marc Budge; Voltaire Nadurata; Wayne Pearce; Howard Hall; Ben Kelly; Angie Spencer; Pauline Chapman; Ernesto Oqueli; Ramesh Sahathevan; Thomas Kraemer; Casey Hair; Dion Stub; Dominique A Cadilhac Journal: BMJ Open Date: 2022-07-18 Impact factor: 3.006
Authors: Kyungil Park; Jong Sung Park; Young Rak Cho; Tae Ho Park; Moo Hyun Kim; Tae Hyun Yang; Doo Il Kim; Jung Hwan Kim; Yong Hwan Lee; Dong Won Lee; Jeongkee Seo; Geun Young Lee; Young Dae Kim Journal: Korean Circ J Date: 2020-08 Impact factor: 3.243