For More Success in Interventions for Myocardial Infarction, Emphasize Total Ischemic Time

Outcomes were more strongly correlated with time since symptom onset than with door-to-balloon time.

Door-to-balloon time (DBT) is an important metric for timely reperfusion with primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). As DBT has decreased nationally, health providers are emphasizing reductions in total ischemic time to further improve outcomes. To examine the relationships between DBT, symptom-to-balloon time (SBT), and outcomes, investigators pooled patient-level data on 3115 participants in 10 randomized trials.

Median SBT was 185 minutes, and median DBT was 46 minutes. The primary outcome measure, infarct size as a percentage of total left ventricular (LV) mass (assessed at a median of 5 days after intervention), increased progressively by 2.0% with intermediate SBT…

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

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)