Door-to-balloon time in acute ST segment elevation myocardial infarction--further experience

Area of Science:

• Cardiology
• Emergency Medicine
• Health Systems Improvement

Background:

• Early coronary reperfusion is the standard treatment for ST-elevation myocardial infarction (STEMI).
• Minimizing delays in achieving coronary artery recanalization is critical for patient outcomes.
• Established protocols aim to streamline the treatment pathway for STEMI patients.

Purpose of the Study:

• To analyze Door-to-Balloon (D2B) times for STEMI patients over a four-year period.
• To evaluate the impact of enhanced pre-hospital care on D2B times.
• To assess compliance with the American College of Cardiology's 90-minute D2B time target.

Main Methods:

• Analysis of D2B times for Emergency Department patients with STEMI.
• Implementation of a protocol to reduce treatment delays.
• Integration of pre-hospital 12-lead electrocardiogram (EKG) transmission by ambulance personnel.
• Comparison of achieved D2B times against the 90-minute benchmark.

Main Results:

• Initial improvement in D2B times was observed after protocol implementation.
• 100% compliance with the 90-minute D2B goal was achieved within the first year.
• Sustained high compliance, reaching 97%, was maintained throughout the remaining study period.

Conclusions:

• Enhanced pre-hospital capabilities, including EKG transmission, significantly improve D2B times for STEMI.
• Protocols focused on reducing delays are effective in meeting critical treatment benchmarks.
• High compliance rates demonstrate the successful implementation of a streamlined STEMI treatment pathway.