When Is Door-to-Balloon Time Most Important?

Retrospective findings suggest that high-risk patients presenting early after symptom onset stand to lose the most from delays in DBT.

Subgroup analyses from studies of primary percutaneous coronary intervention for treatment of myocardial infarction (MI) have suggested that door-to-balloon time (DBT) matters more for some patients than for others. In a retrospective study of data from two trials including 4548 patients with ST-segment-elevation MI, investigators evaluated whether the effect of DBT on 1-year mortality depends on clinical risk, time to presentation, or both. They used a modified Thrombolysis in MI (TIMI) score to assess clinical risk.

The median time from symptom onset to presentation was 112 minutes, and the median DBT was 107 minutes. Patients with DBTs of ≤90 minutes had lower 1-year mortality than patients with DBTs of >90 minutes (3.1% vs. 4.3%; P=0.045…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI