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Acute Coronary Syndrom

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Short Duration of DAPT Versus De-Escalation After Percutaneous Coronary Intervention for Acute Coronary Syndromes Direct comparison of cardiac myosin-binding protein C with cardiac troponins for the early diagnosis of acute myocardial infarction Bare metal versus drug eluting stents for ST-segment elevation myocardial infarction in the TOTAL trial Door to Balloon Time: Is There a Point That Is Too Short? Impact of door-to-balloon time on long-term mortality in high- and low-risk patients with ST-elevation myocardial infarction Successful catheter ablation of electrical storm after myocardial infarction Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney disease Association of the PHACTR1/EDN1 Genetic Locus With Spontaneous Coronary Artery Dissection Outcomes of off- and on-hours admission in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention: A retrospective observational cohort study Association of Thrombus Aspiration With Time and Mortality Among Patients With ST-Segment Elevation Myocardial Infarction: A Post Hoc Analysis of the Randomized TOTAL Trial

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.