Predicting treatment outcomes by door-to-device time and baseline characteristics in STEMI patients undergoing PPCI:...

Primary percutaneous coronary intervention (PPCI) is considered the gold standard for ST-elevation myocardial infarction (STEMI) treatment. While door-to-device (DTD) time critically influences outcomes, its combined impact with baseline characteristics requires further investigation.

In this descriptive cross-sectional analytical study, 163 patients with STEMI undergoing PPCI were recruited through convenience sampling at two hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences between November 2024 and May 2025. Data were collected via hospital records and a researcher-designed checklist covering demographic and clinical variables. Statistical analyses were performed using SPSS version 26.

The mean age of participants was 57.55 ± 13.19 years, and 85.9% were male. The mean DTD time was 108.08 minutes. Longer DTD time was significantly associated with prolonged CCU stay (r = 0.335, p < 0.001) and lower left ventricular ejection fraction (LVEF) (r = -0.232, p = 0.003). Although DTD time did not differ significantly between survivors and non-survivors (p = 0.573), it varied significantly across different degrees of myocardial injury (p = 0.027). Multivariate regression analysis showed that male gender (β = -8.007, p = 0.002), increased DTD time (β = -0.043, p = 0.005), and myocardial injury (β = -14.904, p = 0.016) were significantly associated with reduced LVEF. Increased DTD time (β = 0.014, p < 0.001) and decreased LVEF (β = -0.061, p = 0.003) were significantly associated with longer CCU stays.

While baseline characteristics showed minimal impact, DTD time significantly predicted worse outcomes, including prolonged CCU stays, reduced LVEF, and myocardial injury. These findings emphasize the critical importance of reducing DTD time (<60 minutes) through optimized emergency protocols to improve STEMI management outcomes.