Association between the Door-to-balloon Time and Mid-term Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction

Area of Science:

• Cardiology
• Interventional Cardiology
• Public Health

Background:

• Door-to-balloon time (DTBT) is a critical metric in ST-segment elevation myocardial infarction (STEMI) care.
• While DTBT's association with in-hospital mortality is established, its impact on mid-term outcomes requires further investigation.

Purpose of the Study:

• To examine the relationship between DTBT and mid-term all-cause mortality in STEMI patients receiving primary percutaneous coronary intervention (PCI).

Main Methods:

• A cohort of 309 STEMI patients undergoing primary PCI was categorized into short (<60 min), intermediate (60-120 min), and long (>120 min) DTBT groups.
• Mid-term clinical outcomes, specifically all-cause death, were assessed over a median follow-up of 287 days.
• Multivariate Cox regression analysis was employed, adjusting for factors like Killip class, renal function, and coronary artery disease extent.

Main Results:

• The long DTBT group exhibited a significantly higher incidence of all-cause death compared to the other groups (p<0.001).
• A long DTBT was independently associated with increased mid-term all-cause mortality (HR 2.80, 95% CI 1.26-6.17, p=0.011) after adjusting for covariates.
• Short DTBT was not significantly associated with all-cause death compared to intermediate DTBT (HR 1.00, 95% CI 0.39-2.55, p=0.99).

Conclusions:

• DTBT is a significant predictor of mid-term all-cause mortality in STEMI patients.
• These findings underscore the importance of strict adherence to recommended DTBT protocols to improve long-term survival in STEMI patients undergoing primary PCI.