Open AccessHospital Delays in Reperfusion for ST-Elevation Myocardial Infarction
Author(s) -
Duane S. Pinto,
Ajay J. Kirtane,
Brahmajee K. Nallamothu,
Sabina A. Murphy,
David J. Cohen,
Roger J. Laham,
Donald E. Cutlip,
Eric Bates,
Frederick A. Spencer,
Dave P. Miller,
Joseph P. Carrozza,
Elliott M. Antman,
Christopher P. Can,
C. Michael Gibson
Publication year - 2006
Publication title -
circulation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 7.795
H-Index - 607
eISSN - 1524-4539
pISSN - 0009-7322
DOI - 10.1161/circulationaha.106.638353
Subject(s) - medicine , cardiology , myocardial infarction , reperfusion therapy , st elevation , elevation (ballistics) , myocardial reperfusion , geometry , mathematics
It has been suggested that the survival benefit associated with primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction may be attenuated if door-to-balloon (DB) time is delayed by >1 hour beyond door-to-needle (DN) times for fibrinolytic therapy. Whereas DB times are rapid in randomized trials, they are often prolonged in routine practice. We hypothesized that in clinical practice, longer DB-DN times would be associated with higher mortality rates and reduced PPCI survival advantage. We also hypothesized that in addition to PPCI delays, patient risk factors would significantly modulate the relative survival advantage of PPCI over fibrinolysis.
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