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When reperfusion therapy is provided promptly to patients with ST-segment-elevation MI (STEMI), survival benefits are substantial. However, few institutions meet the guideline-recommended door-to-balloon (D2B) time of less than 90 minutes for primary percutaneous intervention (PCI).
To identify the institutional strategies associated with faster D2B times, researchers sent online surveys to 500 U.S. acute-care hospitals randomly selected from among 818 that had PCI volumes of at least 25 cases in 2004 and that reported their D2B performance to the Centers for Medicaid and Medicaid Services. Most hospitals (73%) responded to the survey.
Median D2B times ranged widely among the hospitals, averaging 100 minutes. Strategies independently associat…