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Nonsystem door-to-balloon time delays often contribute to in-hospital mortality
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Nonsystem reasons for a delay in door-to-balloon time in patients with STEMI presenting at the hospital for PCI were found to be common and associated with high rates of in-hospital mortality, according to findings in a report from the National Cardiovascular Registry.
“Non-system delays, a parameter that has previously not been well studied, are common and associated with high in-hospital mortality rates and adverse events,” trial investigator Rajesh V. Swaminathan, MD, of the New York Presbyterian Hospital, Weill Cornell Medical College, Greenberg Division of Cardiology, New York, told Cardiology Today's Intervention.
Rajesh V. Swaminathan
For the study, Swaminathan and colleagues examined 82,678 patient cases from 1,172 participating centers in the CathPCI Registry from 2009 to June 30, 2011. All patients presented with STEMI and underwent PCI within 24 hours of symptom onset.
Nonsystem reasons were defined as delays in providing procedure consent, difficult vascular access, difficulty crossing lesion, cardiac arrest/need for intubation and other.
Researchers found that nonsystem delays occurred in 12,146 patients (14.7%). In-hospital mortality was 15.1% for patients who experienced delay compared with 2.5% for patients who were treated without delay (P<.01). Post-procedure adverse events, including cardiogenic shock, chronic HF, cerebrovascular accident/stroke, renal failure, any vascular complications and bleeding events within 72 hours, were also more common in these patients.
Additionally, nonsystem delays were found to have occurred more often in patients who were older, women, black, and those who had greater comorbidities.
Disclosure: Swaminathan reports no relevant financial disclosures.
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