Time Is of the Essence

For patients with an ST-segment elevation myocardial infarction (STEMI), rapid treatment with angioplasty can be lifesaving, but timing is essential. The literature indicates that faster door-to-balloon times (the time from arrival at the hospital to the deployment of the balloon or device) are associated with clinically meaningful differences in survival. For each 15-minute decrement in door-to-balloon time from 150 minutes to less than 90 minutes, there are about 6 fewer deaths per 1000 patients treated. As noted by my colleagues and me in a review article in the current New England Journal of Medicine, it is also likely that faster door-to-balloon times benefit quality of life in survivors because of greater myocardial salvage. Among all…