Door-to-balloon time in the treatment of ST segment elevation myocardial infarction in a tertiary care center in Saudi Arabia

Butt, Taimur; Bashtawi, Eyad; Bououn, Badis; Wagley, Bhawoodin; Albarrak, Bandar; Sergani, Hani El; Mujtaba, Salman Ibn; Buraiki, Jehad Al

doi:10.5144/0256-4947.2020.281

Cited by 10 publications

(12 citation statements)

References 18 publications

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“…Several studies have also found that the D2D time in transfer from other hospital groups is shorter than the directed to PCI centre group ( 37 , 38 ). Communication between the referring hospital and the PCI centre can activate the catheterization team and reduce the DTD time, allowing patients transferred from other hospital groups to receive early revascularization therapy.…”

Section: Discussionmentioning

confidence: 99%

Door-to-device time and mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: insight from real world data of Thai PCI Registry

Champasri,

Srimahachota,

Chandavimol

et al. 2023

Cardiovasc Diagn Ther

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Background Timely reperfusion therapy is recommended for patients with ST-segment elevation myocardial infarction (STEMI), and system delay <90 minutes and door-to-device (D2D) time <60 minutes are recommended by the 2017 ESC Guidelines for the management of STEMI patients and have been proposed as a performance measure for triaging patients for primary percutaneous coronary intervention (PCI). However, previous research produced contradictory results regarding the association between D2D time and mortality. Therefore, this study aimed to examine the associations between D2D time and mortality in Thailand. Methods This cohort study included STEMI patients treated with primary PCI in 39 PCI centres in Thailand from February 27, 2018, to August 1, 2019. Patients were eligible if they met the following criteria: primary STEMI diagnosis, symptom onset within 12 hours, and ST-segment elevation of at least 0.1 mV in 2 or more contiguous leads (at least 0.2 mV in V1–V3) or a new left bundle branch block. Results Within 12 hours of symptom onset, 3,874 patients underwent primary PCI. The median D2D time was 54 minutes [interquartile range (IQR) 29–90], and there was a significant difference between patients transferred from other hospitals (44 minutes, IQR 25–77, n=2,871) and patients presented directly to PCI centres (81 minutes, IQR 56–129, n=1,003) (P<0.001). Overall, in-hospital mortality was 7.8%. In a multivariable analysis, adjusting for other predictors of mortality and stratifying according to intervals of D2D time, cumulative in-hospital mortality was significantly higher in patients with a D2D time greater than 90 minutes [hazard ratio (HR) 1.5, 95% confidence interval (CI): 1.0–2.1, P=0.046] but not associated with D2D time shorter than 60 minutes (HR 1.2, 95% CI: 0.8–1.8, P=0.319). Conclusions A D2D time greater than 90 minutes was related to in-hospital mortality in patients with STEMI treated with primary PCI, but a D2D time less than 60 minutes was not consistently associated with D2D time-improved survival in real-world, contemporary practice in Thailand.

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Section: Discussionmentioning

confidence: 99%

Door-to-device time and mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: insight from real world data of Thai PCI Registry

Champasri,

Srimahachota,

Chandavimol

et al. 2023

Cardiovasc Diagn Ther

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“…One of the factors that decreased mortality of STEMI patients is early PCI that suggested that door to balloon time <90 min. [ 38 39 40 ] Our study considered time interval between arrival at PCI hospital and reperfusion therapy. We found longer mean of this time in our patients who died.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mortality for Patients with ST-Elevation Myocardial Infraction after 2-Year Follow-Up

Sadeghi

Jamalian²,

Roohafza³

et al. 2022

Advanced Biomedical Research

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Background: Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI. Materials and Methods: This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. P < 0.05 considered statistically significant. Results: A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age ( P < 0.001), sex ( P = 0.004), transfusion ( P = 0.010), STEMI type ( P < 0.001), number epicardial territories >50% ( P = 0.001), ventilation options ( P < 0.001), smoker ( P = 0.003), and diabetes ( P = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) ( P < 0.001), creatinine ( P < 0.001), hemoglobin ( P < 0.001), low-density lipoprotein-cholesterol (LDL-C) ( P = 0.019), and systolic blood pressure ( P < 0.001). Multiple logistics regression model definition significant predictors for mortality were age ( P < 0.001), heart rate (HR) ( P = 0.007), EF (0.039), LDL-C ( P = 0.002), and preangia ( P = 0.022). Conclusion: The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.

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“…According to the American heart association (AHA) and the American college of cardiology (ACC) guidelines, the door to balloon time should be within 90 minutes for STEMI patients. 28 Less than 50% of patients with STEMI underwent thrombolysis or PCI in the previously reported Indian ACS registries. 29 The treatment and outcomes of ACS were assessed in a large prospective CREATE registry study in India.…”

Section: Discussionmentioning

confidence: 99%

Recent trends in the pattern and long-term management strategy of patients diagnosed with acute coronary syndrome in India: an observational study

Nayak

Patel²,

Chaturvedi³

et al. 2022

Int J Res Med Sci

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Background: The understanding of demographic patterns and the real-world management practices for patients with acute coronary syndrome (ACS) will facilitate optimizing the management strategies for ACS based on the patient’s clinical profile and the associated risk factors in Indian patients. Hence, this study determined the demographic details and the treatment patterns in Indian patients with ACS.Methods: The RECent trends in the pattern and lOng-term management stRategy of patients Diagnosed with acute coronary syndrome in India (RECORD ACS-2) study was a real-world, retrospective, cross-sectional, observational study conducted at various centres across India between 2021 and 2022. The study outcomes included the demographic profile and therapeutic management in patients with ACS.Results: A total of 9945 patients with a mean age of 59 years were included. The ACS was commonly observed in the age group of 41-70 years with highest incidence in the age group of 51-60 years. The ST-elevation myocardial infarction (STEMI) was most common (53.2%) presentation. Hypertension (37.2%) and dyslipidemia (29.3%) followed by diabetes (21.3%) were the most common comorbidities. Single vessel disease was the most common angiographic feature (58%). Percutaneous coronary intervention was the most preferred management strategy (57%). Ticagrelor was the most preferred loading (68.3%) as well as maintenance (71.2%) P2Y12 inhibitor in ACS patients. Most of the patients (81.8%) had received high intensity statin therapy for the secondary prevention of the disease.Conclusions: The prevalence of ACS was high between 51-60 years of age, more so in males, smokers, and physically less active patients. Associated comorbidities were hypertension, dyslipidemia and diabetes. Incidence of STEMI was high, and more than half of the patients underwent PCI. Ticagrelor was the most preferred P2Y12 inhibitor in ACS patients for loading as well as maintenance therapy.

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Door-to-balloon time in the treatment of ST segment elevation myocardial infarction in a tertiary care center in Saudi Arabia

Cited by 10 publications

References 18 publications

Door-to-device time and mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: insight from real world data of Thai PCI Registry

Door-to-device time and mortality in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention: insight from real world data of Thai PCI Registry

Predictors of Mortality for Patients with ST-Elevation Myocardial Infraction after 2-Year Follow-Up

Recent trends in the pattern and long-term management strategy of patients diagnosed with acute coronary syndrome in India: an observational study

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