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Management of Myocardial Revascularization Failure: An Expert Consensus Document of the EAPCI Canadian Multicenter Chronic Total Occlusion Registry: Ten-Year Follow-Up Results of Chronic Total Occlusion Revascularization Complete or Culprit-Only Revascularization for Patients With Multivessel Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Pairwise and Network Meta-Analysis of Randomized Trials Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial Subcutaneous Selatogrel Inhibits Platelet Aggregation in Patients With Acute Myocardial Infarction Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study Chronic Kidney Disease and Coronary Artery Disease Healed Culprit Plaques in Patients With Acute Coronary Syndromes The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction
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Review Article2015 Nov-Dec;58(3):230-40.

JOURNAL：Prog Cardiovasc Dis. Article Link

Door to Balloon Time: Is There a Point That Is Too Short?

Sutton NR, Gurm HS et al. Keywords: Coronary angiography; Myocardial infarction; Outcome assessment; Percutaneous coronary intervention; Quality improvement; Reperfusion

ABSTRACT

The duration of ischemic time is directly related to permanent myocardial damage and mortality in the setting of ST-elevation myocardial infarction (STEMI). Rapidly restoring myocardial blood flow to limit the total ischemic time is a priority. The time duration between a patient entering the medical system and being treated with percutaneous coronary intervention to open the occluded culprit vessel is termed door-to-balloon (DTB) time, which is publicly reported and used to judge hospital quality of care. While longer DTB time is associated with increased mortality in the setting of STEMI, efforts to lower DTB time have not translated into decreased mortality. Here we review the literature on DTB time, explore the factors thought to influence the interpretation of the association between DTB time and mortality, and make suggestions on goals for future efforts related to DTB time.
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