Association of door-to-balloon time and clinical factors with hospital shifts

Abstract

Background: In ST-segment elevation myocardial infarction, the main therapy is early arterial reperfusion, performed by primary percutaneous coronary intervention. The recommended door-to-balloon time is <90 minutes. The objective of this study was to associate the door-to-balloon time and clinical factors with hospital shifts. Methods: This was a cross-sectional observational study, part of the Catarina Heart Study. We analyzed patients diagnosed with ST-segment elevation myocardial infarction in hospitals of the metropolitan area of Florianópolis, from 2016 to 2020. The qualitative variables were analyzed using the Chi-square test, and the quantitative variables were analyzed using the Student’s t test and Mann-Whitney test. Results: A total of 318 patients were analyzed, with a mean age of 58.7±11.4 years, predominantly male (71.7%) and hypertensive (53.7%). The median door-to-balloon time was significantly lower in the group seen on weekdays compared to the group seen on weekends, respectively, 71.0 (51.0-126.0) minutes and 91.0 (71.0-123.0) minutes (p=0.028). There was no difference in the door-to-balloon time in the night shift and in off-hours. Individuals undergoing primary percutaneous coronary intervention during the night shift showed a non-significant tendency for higher mortality rates from any cause (1.9%) compared to those seen during the day shift (0.0%; p=0.057). Conclusion: Patients with ST-segment elevation myocardial infarction seen on weekdays have shorter door-to-balloon time.