ArticleThe American journal of cardiology2009
Association of door-to-balloon time and mortality in patients > or =65 years with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.
Article in The American journal of cardiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Delay in reperfusion with transradial percutaneous coronary intervention for ST-elevation myocardial infarction: Might some delays be acceptable?American heart journal · 2014Trial
- Factors associated with longer time to treatment for patients with suspected acute coronary syndromes: a cohort study.Circulation. Cardiovascular quality and outcomes · 2014Trial
- Door-to-Balloon Time and Mortality Among Patients Undergoing Primary PCI, Challenges and Experience from Somalia's Largest PCI Center.International journal of general medicine · 2024Article
- Sex Differences in Symptom Complexity and Door-to-Balloon Time in Patients With ST-Elevation Myocardial Infarction.The American journal of cardiology · 2023Article
- Thrombolytic Therapy for ST-Elevation Myocardial Infarction Presenting to non-Percutaneous Coronary Intervention Centers During the COVID-19 Crisis.Current cardiology reports · 2021Review
- High quality process of care increases one-year survival after acute myocardial infarction (AMI): A cohort study in Italy.PloS one · 2019Article
- Door-to-balloon time and the determining factors in a tertiary cardiac center in Nepal.Indian heart journal · 2018Article
- The Management and Prognostic Factors of Acute Coronary Syndrome: Evidence from the Taiwan Acute Coronary Syndrome Full Spectrum Registry.Acta Cardiologica Sinica · 2017Review
- Impact of around-the-clock in-house cardiology fellow coverage on door-to-balloon time in an academic medical center.Vascular health and risk management · 2017Article
- Sex differences in long-term mortality among acute myocardial infarction patients: Results from the ISAR-RISK and ART studies.PloS one · 2017Article
- Association of Guideline-Based Admission Treatments and Life Expectancy After Myocardial Infarction in Elderly Medicare Beneficiaries.Journal of the American College of Cardiology · 2016Article
- Effects of Door-to-Balloon Times on Outcomes in Taiwanese Patients Receiving Primary Percutaneous Coronary Intervention: A Report of Taiwan Acute Coronary Syndrome Full Spectrum Registry.Acta Cardiologica Sinica · 2015Article
- Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention.World journal of cardiology · 2014Review
- Performance of reperfusion therapy and hospital mortality in ST-elevation myocardial infarction patients with non-chest pain complaints.Yonsei medical journal · 2014Article
- Understanding the volume-outcome effect in cardiovascular surgery: the role of failure to rescue.JAMA surgery · 2014Article
- The prevalence and outcomes of transradial percutaneous coronary intervention for ST-segment elevation myocardial infarction: analysis from the National Cardiovascular Data Registry (2007 to 2011).Journal of the American College of Cardiology · 2013Article
- Thrombolysis in the age of Primary Percutaneous Coronary Intervention: Mini-Review and Meta-analysis of Early PCI.International journal of health sciences · 2013Article
- Predictors of ambulance transport in patients with ST-elevation myocardial infarction.Prehospital and disaster medicine · 2012Article
- Improvements in door-to-balloon time in the United States, 2005 to 2010.Circulation · 2011Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Current guidelines recommend patients with ST-elevation myocardial infarction receive primary percutaneous coronary intervention (PCI) within 90 minutes of admission, although there are conflicting data regarding the relation between time to treatment and mortality in these patients. We used logistic regression analyses employing a fractional polynomial model to evaluate the association between door-to-balloon time and 1-year mortality in patients with ST-elevation myocardial infarction > or =65 years old undergoing primary PCI from 1994 to 1996 (n = 1,932). Median door-to-balloon time was 128 minutes (interquartile range 92 to 178, 24.2% treated within 90 minutes). Overall 1-year mortality was 21.1%. Longer door-to-balloon times were associated with higher 1-year mortality in a continuous, nonlinear fashion (30 minutes 10.9%, 60 minutes 13.6%, 90 minutes 16.5%, 120 minutes 19.5%, 150 minutes 22.5%, 180 minutes 25.3%, 210 minutes 27.9%). The nature of the association between door-to-balloon time and 1-year mortality was best modeled by a second-degree fractional polynomial (p <0.001). Findings were similar after multivariable adjustment as any increase in door-to-balloon time was associated with successive increases in patients' 1-year mortality (30 minutes 8.8%, 60 minutes 12.9%, 90 minutes 16.6%, 120 minutes 19.9%, 150 minutes 22.9%, 180 minutes 25.5%, 210 minutes 27.7%). In conclusion, any delay in primary PCI is associated with increased 1-year mortality, suggesting efforts should focus on decreasing time to treatment as much as possible, even among those centers currently providing primary PCI within 90 minutes.
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