Community-based procedure decreased door-to-balloon time in patients with STEMI

American Heart Association Scientific Sessions 2009

A community-based reporting system decreased door-to-balloon time in patients with STEMI, and further led to a decreased incidence of myocardial necrosis, according to data presented today.

Researchers from New York assessed data for 189 patients with STEMI who underwent primary PCI before and after a city-wide protocol for reporting was put in place by the Fire Department of New York City. in October 2007.

Door-to-balloon time was defined as emergency room nursing triage to intra-coronary device time. The researchers obtained and plot-fitted serial, timed creatine kinase-MB levels from all patients. A curve estimation regression model was used to evaluate the effect of door-to-balloon time on myocardial necrosis.

Data indicated patient variables were similar across all time periods. A significant decrease was found in mean door-to-balloon time following initiation of the protocol when compared with before the protocol (78 minutes vs. 95 minutes; P<.01).

In addition, a significant association was found between the area under the curve CK-MB and door-to-balloon time (P=.2; P=.02). Door-to-balloon time remained a significant predictor for area under the curve CK-MB (P=.03).

At the AHA’s Scientific Sessions 2006, the organization launched the D2B program along with the American College of Cardiology. The groups set 90 minutes or less as the target time. – by Jennifer Southall

Minutello RM. #4192. Presented at: the American Heart Association’s Annual Meeting; Nov. 14-18; Orlando, Fla.