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Acute Coronary Syndrom

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From Early Pharmacology to Recent Pharmacology Interventions in Acute Coronary Syndromes High-Sensitivity Troponin I Levels and Coronary Artery Disease Severity, Progression, and Long-Term Outcomes Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial Long-Term Prognostic Implications of Previous Silent Myocardial Infarction in Patients Presenting With Acute Myocardial Infarction Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI): an open-label, randomised controlled trial An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association Single-Molecule hsTnI and Short-Term Risk in Stable Patients With Chest Pain Myocardial Infarction in Young Women Culprit versus multivessel coronary intervention in ST-segment elevation myocardial infarction: a meta-analysis of randomized trials
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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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