Coronary artery diseaseEffect of Onset-to-Door Time and Door-to-Balloon Time on Mortality in Patients Undergoing Percutaneous Coronary Interventions for ST-Segment Elevation Myocardial Infarction
Section snippets
Methods
The main database used in the present study was the New York State Percutaneous Coronary Intervention Reporting System registry, which was developed in 1991 for the purpose of collecting information on all patients undergoing percutaneous coronary intervention (PCI) in New York's nonfederal hospitals. Deaths occurring among New York State patients after discharge from the hospital were obtained by matching the Percutaneous Coronary Intervention Reporting System to New York's Vital Statistics
Results
Table 1 lists the patient risk factors stratified by the DTB time (<90 minutes) and OTD time (<4 hours). The median follow-up period was 413 days. As indicated in Table 1, 2,368 patients (46.5%) had a DTB time of <90 minutes and 4,092 patients (88.9%) had an OTD time of <4 hours; 1,878 patients (36.9%) had both an OTD time of <4 hours and a DTB time of <90 minutes.
Significant differences were found among the DTB time and OTD time groups for many patient risk factors. Older patients, black
Discussion
The time from the onset of symptoms to balloon time, which is the OTD time plus the DTB time, has been hypothesized to be an important determinant of patient outcomes, and a variety of studies have examined the effect of this interval or subsets of it on patient outcomes.2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12
Our study explored the combined effect of DTB time and OTD time on longer term mortality for patients with STEMI undergoing primary PCI in a large region (New York State). We found that women,
Acknowledgment
We thank the New York State Cardiac Advisory Committee for their encouragement and support of this study; and Paula Waselauskas, Kimberly Cozzens, Cynthia Johnson, and the cardiac catheterization laboratories of the participating hospitals for their tireless efforts to ensure the timeliness, completeness, and accuracy of the registry data. We also acknowledge that some of the information contained in our study was derived from data provided by the Bureau of Vital Statistics, New York City
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