Symptom Onset–to-Balloon Is More Important Than Door-to-Balloon Time

For patients with ST-segment-elevation myocardial infarctions, presenting within 2 hours led to significantly better outcomes.

Current guidelines recommend percutaneous coronary intervention (PCI) be performed within 90 minutes of first medical contact (so-called “door-to-balloon time”) in patients who suffer ST-segment-elevation myocardial infarctions (STEMIs). Now, in a large Japanese observational study, investigators looked at the effect of symptom onset–to-balloon time instead.

In 3391 STEMI patients, the incidence of the combined endpoint of death or heart failure was significantly lower with symptom-to-balloon time of ≤3 hours than with symptom-to-balloon time of >3 hours (13.5% vs. 19.2%). This association persisted after adjustment for confounders. The difference was much smaller and no longer significant when door-to-balloon times of ≤90 minutes and >90 mi…

Reviewing Author

Kirsten E. Fleischmann, MD, MPH

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association

Kirsten E. Fleischmann, MD, MPH

Disclosures

Grant/Research SupportNational Institutes of Health

Leadership Positions in Professional SocietiesAmerican College of Cardiology/American Heart Association